Erdman, Barry Ellis

Erdman, Barry Ellis is an sole proprietor health care provider with primary practice located at 2005 S Lake Park Rd , Appleton WI 54915-4155. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Erdman, Barry Ellis can be contacted via phone (920) 882-9990.

Contact Information

Primary practice address
2005 S Lake Park Rd Appleton WI 54915-4155
Phone: (920) 882-9990
Fax: (920) 882-9544
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 616025 Wisconsin

Profile Details

NPI number 1245210624
LBN Legal business name Erdman, Barry Ellis
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 20th, 2006
Last updated Jan 30th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245210624 NPPES
Wisconsin Other 010556903-011 ANTHEM BLUE CROSS BLUE S
Wisconsin MEDICAID 43206700 ANTHEM BLUE CROSS BLUE S

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