| Harry W Eichenbaum Md Pa | |
|
4320 Central Ave St Petersburg FL 33711-1141 | |
| (727) 345-3621 | |
| (727) 381-4934 |
| Full Name | Harry W Eichenbaum Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4320 Central Ave, St Petersburg, Florida |
| Authorized Official Name and Position | Mark S Eichenbaum (PRESIDENT) |
| Authorized Official Contact | 7273453621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harry W Eichenbaum Md Pa 4320 Central Ave Saint Petersburg FL 33711-1141 Ph: (727) 345-3621 | Harry W Eichenbaum Md Pa 4320 Central Ave St Petersburg FL 33711-1141 Ph: (727) 345-3621 |
| NPI Number | 1265671549 |
|---|---|
| Provider Enumeration Date | 02/11/2009 |
| Last Update Date | 03/01/2012 |
| Medicare PECOS PAC ID | 0446300495 |
|---|---|
| Medicare Enrollment ID | O20090612000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265671549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MES 100677 (Florida) | Primary |
| Provider Name | Mark Eichenbaum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871764977 PECOS PAC ID: 8426105685 Enrollment ID: I20090622000314 |
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