Provider Demographics
NPI:1518037043
Name:DASH, ERIC M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:DASH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1916 E 1ST ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2777
Mailing Address - Country:US
Mailing Address - Phone:307-682-4954
Mailing Address - Fax:307-472-4414
Practice Address - Street 1:1916 E 1ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2777
Practice Address - Country:US
Practice Address - Phone:307-682-4954
Practice Address - Fax:307-472-4414
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE1647213ES0103X
WY135213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE16470OtherLICENSE
CA952954145OtherTAX ID
CAE16470OtherLICENSE