Ericson, David John
Ericson, David John is an individual health care provider with primary practice located at 520 Upper Chesapeake Dr Ste 206 , Bel Air MD 21014. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Ericson, David John can be contacted via phone (410) 879-9100.Contact Information
Primary practice address
520 Upper Chesapeake Dr Ste 206
Bel Air MD 21014
Phone: (410) 879-9100
Fax: (410) 638-0408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | MA057338 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | C0007193 | Maryland |
Profile Details
| NPI number | 1568560761 |
|---|---|
| LBN Legal business name | Ericson, David John |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 31st, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568560761 | NPPES |
| Montana | MEDICAID | 435383 |
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