Healthcare Provider Details

I. General information

NPI: 1447517156
Provider Name (Legal Business Name): ERIK THOMAS INTERVAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 COAL VALLEY RD STE 511
CLAIRTON PA
15025-3729
US

IV. Provider business mailing address

575 COAL VALLEY RD STE 511
CLAIRTON PA
15025-3729
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-2300
  • Fax:
Mailing address:
  • Phone: 412-681-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD465031
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: