Provider Demographics
NPI:1487232682
Name:LADWIG, ERIC MARTIN (NP-C)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MARTIN
Last Name:LADWIG
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 S BATES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6075
Mailing Address - Country:US
Mailing Address - Phone:208-705-0656
Mailing Address - Fax:
Practice Address - Street 1:2290 W PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8424
Practice Address - Country:US
Practice Address - Phone:208-772-7994
Practice Address - Fax:208-772-5916
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID49472163W00000X
ID67626363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse