Individual
DR. ERIC TYLER LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10635 PARK RD STE I, CHARLOTTE, NC 28210-8408
(704) 495-6025
Mailing address
5960 FAIRVIEW RD STE 500, CHARLOTTE, NC 28210-3113
(704) 495-6334
(704) 817-7219
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200000867
NC
207R00000X
Internal Medicine Physician
92947
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127G7
BCBS
NC
05
—
1861414849
—
NC
05
—
89127G7
—
NC
05
—
N00868
—
SC
Enumeration date
07/25/2006
Last updated
11/11/2024
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