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General NPI Number Information
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NPI Number | 1740267640
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Entity Type | Individual
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Provider Name | ERIC DAVID SOLOMON D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 1395 S MARIETTA PKWY SE BLDG 100 STE 102
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City | MARIETTA
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State | GA
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Zip | 30067-4440
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Country | US
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Telephone | 770-425-8700
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Fax | 770-425-8740
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Provider Business Mailing Address
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Address Line | 1395 S MARIETTA PKWY SE BLDG 100 STE 102
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City | MARIETTA
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State | GA
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Zip | 30067-4440
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Country | US
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Telephone | 770-425-8700
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Fax | 770-425-8740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 046649
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License Number State | GA
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