MEDICARE: DR. ERIK D OBERG 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	207P00000X	Emergency Medicine Physician	P2502	TX
2	207P00000X	Emergency Medicine Physician	83775	GA
3	207P00000X	Emergency Medicine Physician	01057915A	IN
4	2083A0100X	Aerospace Medicine Physician	01057915A	IN
5	207P00000X	Emergency Medicine Physician	36547	SC

General Provider Information

NPI Number	:	1538140223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIK D OBERG M.D.

Provider Business Mailing Address
First Line	:	921 PARROT CREEK WAY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-9055
Country	:	US
Telephone Number	:	843-693-2154
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 PARROT CREEK WAY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-9055
Country	:	US
Telephone Number	:	843-693-2154
Fax Number	:

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	11/02/2022

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