Individual
ERIC D. SHOULDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MACCORKLE AVENUE SE, HOSPITALIST PROGRAM, CHARLESTON, WV 25304
(304) 388-5848
(304) 388-9654
Mailing address
3200 MACCORKLE AVE SE, STE B16, CHARLESTON, WV 25304-1227
(304) 388-7782
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21144
WV
208M00000X
Hospitalist Physician
Primary
21144
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1809361000
—
WV
05
—
2402475
—
OH
05
—
64089113
—
KY
01
—
P00045010
RAILROAD MEDICARE
—
Enumeration date
06/20/2006
Last updated
03/18/2016
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