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Individual

ERIC L SANDWITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1032 MAR WALT DR, SUITE 230, FORT WALTON BEACH, FL 32547-6661
(850) 862-3194
(850) 862-4423
Mailing address
1032 MAR WALT DR, SUITE 230, FORT WALTON BEACH, FL 32547-6661
(850) 862-3194
(850) 862-4423

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME90193
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274071100
FL
01
P00777005
RAILROAD MEDICARE
FL
Enumeration date
09/22/2005
Last updated
09/08/2016
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