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NPI Code Detail

MEDICARE: DR. ERIC MAST DO

MEDICARE:  DR. ERIC  MAST  DO
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
1207Q00000XFamily Medicine Physician34-006386OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2080100471OTHEROHRAILROAD MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437156296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC MAST DO
Provider Business Mailing Address
First Line : 1019 PIERCE ST
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4633
Country : US
Telephone Number : 419-626-1118
Fax Number :
Provider Business Practice Location Address
First Line : 1019 PIERCE ST
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-4633
Country : US
Telephone Number : 419-626-1118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 03/03/2011

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Directions to “ DR. ERIC MAST DO” Practice Location

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