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Individual

MR. DAVID JOHN ERICSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
520 UPPER CHESAPEAKE DR STE 206, BEL AIR, MD 21014
(410) 879-9100
(410) 638-0408
Mailing address
520 UPPER CHESAPEAKE DR STE 206, BEL AIR, MD 21014-4360
(410) 879-9100
(410) 638-0408

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0007193
MD
363AM0700X
Medical Physician Assistant
MA057338
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
435383
MT
Enumeration date
09/20/2006
Last updated
07/31/2019
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