MEDICARE: MATTHEW D. ERULKAR MSSA

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

General Provider Information

NPI Number	:	1225499163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW D. ERULKAR MSSA

Provider Business Mailing Address
First Line	:	1513 THORNAPPLE AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44301-2030
Country	:	US
Telephone Number	:	610-420-4996
Fax Number	:	216-268-2460

Provider Business Practice Location Address
First Line	:	2114 NOBLE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1725
Country	:	US
Telephone Number	:	216-630-0364
Fax Number	:

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

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	03/18/2016

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