Eric E. Petterson P.C.

LBN: Eric E. Petterson P.C.
Eric E. Petterson P.C. is an health care organization with primary practice located at 1 S Main St , Shenandoah PA 17976. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as the primary health care specialty. Eric E. Petterson P.C. can be contacted via phone (570) 861-0802, or through Petterson, Eric Evan via phone (570) 462-1040.

Contact Information

Primary practice address
1 S Main St Shenandoah PA 17976
Phone: (570) 861-0802
Fax: (570) 462-1040
Website:
Map and Directions
Authorized official contact:
Name: Petterson, Eric Evan Doctor of Medicine (MD)
Phone: (570) 462-1040

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X MD039636L Pennsylvania

Profile Details

NPI number 1518417690
LBN Legal business name Eric E. Petterson P.C.
DBA Doing business as
Authorized official Petterson, Eric Evan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2016
Last updated Nov 11th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518417690 NPPES
Pennsylvania MEDICAID 0010036980010

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