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Individual

ERIC S DILDINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2275 NE DOCTORS DR., SUITE 5, BEND, OR 97701
(541) 706-7715
(541) 706-7742
Mailing address
PO BOX 5579, BEND, OR 97708-5579
(541) 706-7715
(541) 706-7742

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01169
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00479095
RAILROAD MEDICARE
OR
01
11745011
CAQH ID
OR
05
500608143
OR
Enumeration date
11/14/2006
Last updated
04/04/2013
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