Individual
LUIS H. ERASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, SUITE 6270, PHILADELPHIA, PA 19107-4824
(215) 955-4901
(215) 923-0835
Mailing address
111 S 11TH ST, SUITE 6270, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD434112
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0267414
—
NJ
05
—
102612347
—
PA
Enumeration date
06/17/2006
Last updated
05/02/2012
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