Provider Demographics
NPI:1245597087
Name:WAIT, ERIN NICOLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:WAIT
Suffix:
Gender:F
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:EASTERN OBGYN
Mailing Address - Street 2:48 MEDICAL PARK EAST DRIVE SUITE 355
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235
Mailing Address - Country:US
Mailing Address - Phone:205-838-3036
Mailing Address - Fax:205-838-5832
Practice Address - Street 1:EASTERN OBGYN
Practice Address - Street 2:48 MEDICAL PARK EAST DRIVE SUITE 355
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235
Practice Address - Country:US
Practice Address - Phone:205-838-3036
Practice Address - Fax:205-838-5832
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.33064207V00000X
AL33064207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL206148Medicaid