Healthcare Provider Details
I. General information
NPI: 1205963709
Provider Name (Legal Business Name): ERIK IAN KOCHERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/28/2007
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 S FRONT ST
HARRISBURG PA
17101
US
IV. Provider business mailing address
111 S FRONT ST
HARRISBURG PA
17101-2010
US
V. Phone/Fax
- Phone: 717-988-0000
- Fax:
- Phone: 717-231-8900
- Fax: 717-782-5716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | C7-0003466 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD435383 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: