1528005394 NPI number — DR. ERIC S EINFALT MD

Table of content: DR. ERIC S EINFALT MD (NPI 1528005394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528005394 NPI number — DR. ERIC S EINFALT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EINFALT
Provider First Name:
ERIC
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528005394
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 643403
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45264-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-299-4564
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
810 FAIRGROVE CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-9617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-326-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  35886 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1221Y . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00208930 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: Q35886 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7388297 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: D8973 . This is a "MEDCOST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 891221Y , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".