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NPI Code Detail

MEDICARE: MR. ERIC MARTIN LADWIG NP-C

MEDICARE: MR. ERIC MARTIN LADWIG NP-C
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
1163W00000XRegistered Nurse49472ID
2363LF0000XFamily Nurse Practitioner67626ID

General Provider Information

NPI Number : 1487232682
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERIC MARTIN LADWIG NP-C
Provider Business Mailing Address
First Line : 4003 S BATES RD
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99206-6075
Country : US
Telephone Number : 208-705-0656
Fax Number :
Provider Business Practice Location Address
First Line : 2290 W PRAIRIE AVE
Second Line :
City : COEUR D ALENE
State : ID
Zip : 83815-8424
Country : US
Telephone Number : 208-772-7994
Fax Number : 208-772-5916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 06/20/2023

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