Provider Demographics
NPI:1043369655
Name:LEDIN, ERIC WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WILLIAM
Last Name:LEDIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EVERGREEN LN
Mailing Address - Street 2:UNIT 7
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1557
Mailing Address - Country:US
Mailing Address - Phone:508-478-3158
Mailing Address - Fax:
Practice Address - Street 1:2 EVERGREEN LN
Practice Address - Street 2:UNIT 7
Practice Address - City:HOPEDALE
Practice Address - State:MA
Practice Address - Zip Code:01747-1557
Practice Address - Country:US
Practice Address - Phone:508-478-3158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4400562OtherUNITED HEALTHCARE
MA1031399OtherAMERICAN SPECIALTY HEALTH
MAY36646OtherBLUE CROSS BLUE SHIELD
MA2158375OtherAETNA
MAW201513OtherCIGNA
MA1613332Medicaid
MAW201513OtherCIGNA