Provider Demographics
NPI:1164836607
Name:ERIAN, MARC-FERNAND
Entity Type:Individual
Prefix:
First Name:MARC-FERNAND
Middle Name:
Last Name:ERIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 BRANCH OAK WAY
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5606
Mailing Address - Country:US
Mailing Address - Phone:210-885-1388
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO ST RM C256
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-3010
Practice Address - Country:US
Practice Address - Phone:415-885-7758
Practice Address - Fax:415-885-7876
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP2-00521492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology