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NPI Code Detail

MEDICARE: DR. ERIC TYLER LANDIS MD

MEDICARE: DR. ERIC TYLER LANDIS MD
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
1207R00000XInternal Medicine Physician92947SC
2207R00000XInternal Medicine Physician200000867NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2127G7OTHERNCBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861414849
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC TYLER LANDIS MD
Provider Business Mailing Address
First Line : 5960 FAIRVIEW RD STE 500
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3113
Country : US
Telephone Number : 704-495-6334
Fax Number :
Provider Business Practice Location Address
First Line : 10635 PARK RD STE I
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8408
Country : US
Telephone Number : 704-495-6334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 06/02/2026

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