Provider Demographics
NPI:1235223108
Name:KASS, ERIK (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:KASS
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 1:8000 OLD GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2427
Mailing Address - Country:US
Mailing Address - Phone:301-778-3150
Mailing Address - Fax:301-778-3149
Practice Address - Street 1:7986 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE B
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2458
Practice Address - Country:US
Practice Address - Phone:301-881-1736
Practice Address - Fax:301-664-6470
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234897207Y00000X
MDD0051250207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI09630Medicare UPIN