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NPI Code Detail

MEDICARE: ERIN K. WILLITS MD

MEDICARE:   ERIN K. WILLITS  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
1207K00000XAllergy & Immunology PhysicianDR.0063320CO
2207K00000XAllergy & Immunology Physician12626AWY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3883496OTHERCOMEDICARE PTAN
4W31876OTHERWYMEDICARE PTAN

Other Identifiers

General Provider Information

NPI Number : 1962766402
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN K. WILLITS MD
Provider Business Mailing Address
First Line : PO BOX 603725
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-3725
Country : US
Telephone Number : 828-575-2625
Fax Number : 828-350-2174
Provider Business Practice Location Address
First Line : 2121 E HARMONY RD UNIT 290
Second Line :
City : FORT COLLINS
State : CO
Zip : 80528-3402
Country : US
Telephone Number : 970-221-2370
Fax Number : 970-221-9654
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2012
Last Update Date : 10/18/2023

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