MEDICARE: DR. ERIC ALFRED ORISTIAN M.D.

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	208600000X	Surgery Physician	DOO24564	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9561	OTHER	MD	CAREFIRST BCBS NUMBER
2	25306	OTHER	MD	UNITED/MDIPA/OPT CHOICE
3	D0024564	OTHER	MD	MARYLAND LICENSE

General Provider Information

NPI Number	:	1154301380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ALFRED ORISTIAN M.D.

Provider Business Mailing Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 216
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-942-4080
Fax Number	:	301-942-4082

Provider Business Practice Location Address
First Line	:	2730 UNIVERSITY BLVD W
Second Line	:	SUITE 216
City	:	WHEATON
State	:	MD
Zip	:	20902-1905
Country	:	US
Telephone Number	:	301-942-4080
Fax Number	:	301-942-4082

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	07/18/2008

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