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Individual

ERIC JOHN CARLSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
100 E LANCASTER AVE, 353 MEDICAL OFFICE BUILDING EAST, WYNNEWOOD, PA 19096-3450
(610) 649-9021
(610) 649-8058
Mailing address
100 E LANCASTER AVE, 353 MEDICAL OFFICE BUILDING EAST, WYNNEWOOD, PA 19096-3450
(610) 649-9021
(610) 649-8058

Taxonomy

Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
25MB06319700
NJ
207VM0101X
Maternal & Fetal Medicine Physician
Primary
OS011047L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00184927
PA
01
00866773000
BC/BS KEYSTONE, PERSONAL
PA
01
0184927006
AMERICHOICE
PA
01
02640
HEALTH PARTNERS
PA
01
1652891
BC/BS HIGHMARK GROUP
PA
01
2330386000
BC/BS KEY, PER. GROUP
PA
01
30018989
KEYSTONE MERCY GROUP
PA
01
30018993
KEYSTONE MERCY
PA
01
33657
HEALTH PARTNERS
PA
01
33658
HEALTH PARTNERS
PA
01
33659
HEALTH PARTNERS
PA
01
3716959
AETNA US HEALTHCARE GROUP
PA
01
3716982
AETNA US HEALTHCARE HMO
PA
01
5824670
AETNA US HEALTHCARE
PA
01
923742
BC/BS SHIELD HIGHMARK
PA
Enumeration date
05/04/2006
Last updated
07/08/2007
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