Provider Demographics
NPI:1235128661
Name:FIEDLER, ERIC P (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:P
Last Name:FIEDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MARKET STREET
Mailing Address - Street 2:UNIT 17 PMB 286
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043
Mailing Address - Country:US
Mailing Address - Phone:717-545-9300
Mailing Address - Fax:717-540-3700
Practice Address - Street 1:1200 MARKET STREET
Practice Address - Street 2:UNIT 17 PMB 286
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043
Practice Address - Country:US
Practice Address - Phone:717-545-9300
Practice Address - Fax:717-540-3700
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-07-21
Deactivation Date:2013-05-14
Deactivation Code:
Reactivation Date:2017-02-22
Provider Licenses
StateLicense IDTaxonomies
PAMD050792L207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F89850Medicare UPIN