1013220110 NPI number — MS. ERIKA M NIGAM RPA-C

Table of content: MS. ERIKA M NIGAM RPA-C (NPI 1013220110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013220110 NPI number — MS. ERIKA M NIGAM RPA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIGAM
Provider First Name:
ERIKA
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GORDON
Provider Other First Name:
ERIKA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013220110
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 602478
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-2478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-403-6100
Provider Business Mailing Address Fax Number:
704-403-6131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2435 W. BELVEDERE AVENUE
Provider Second Line Business Practice Location Address:
HOFFBERGER BUILDING, SUITE 32
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-601-0900
Provider Business Practice Location Address Fax Number:
410-601-0901
Provider Enumeration Date:
07/16/2010

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: 363AS0400X , with the licence number:  014066 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: 0010-04220 , 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: 1013220110 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1662PA , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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