BARRY ELLIS ERDMAN DPM NPI 1245210624

NPI Information

NPI: 1245210624
Provider Name: BARRY ELLIS ERDMAN, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2005 S LAKE PARK RD
APPLETON, WI
ZIP 54915
Phone: (920) 882-9990
Get Directions

Barry Ellis Erdman, DPM is a podiatrist in Appleton, WI. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Barry Ellis Erdman, DPM NPI is 1245210624. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2005 S LAKE PARK RD
APPLETON, WI
ZIP 54915-155
Phone: (920) 882-9990
Fax: (920) 882-9544

The NPI 1245210624 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 1/20/2006 and was last updated on 1/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		616025	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	010556903-011	OTHER	WISCONSIN	ANTHEM BLUE CROSS BLUE S
2	000082031	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN
3	4764700001	MEDICARE NSC	WISCONSIN
4	43206700	MEDICAID	WISCONSIN
5	T93136	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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