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Individual

DR. ERIC MAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1019 PIERCE ST, SANDUSKY, OH 44870-4633
(419) 626-1118
Mailing address
1019 PIERCE ST, SANDUSKY, OH 44870-4633
(419) 626-1118

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-006386
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0257985
OH
01
080100471
RAILROAD MEDICARE PTAN
OH
Enumeration date
07/07/2005
Last updated
03/03/2011
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