MEDICARE: MR. ERIC EGHAN MSW, LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	S.1303301	OH

General Provider Information

NPI Number	:	1013327667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC EGHAN MSW, LSW

Provider Business Mailing Address
First Line	:	7422 MAPLE SPICE AVE
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-8073
Country	:	US
Telephone Number	:	412-294-3175
Fax Number	:

Provider Business Practice Location Address
First Line	:	7422 MAPLE SPICE AVE
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-8073
Country	:	US
Telephone Number	:	412-294-3175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	07/23/2020

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