Provider Demographics
NPI:1538140223
Name:OBERG, ERIK D (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:D
Last Name:OBERG
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 1:921 PARROT CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9055
Mailing Address - Country:US
Mailing Address - Phone:843-693-2154
Mailing Address - Fax:
Practice Address - Street 1:921 PARROT CREEK WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9055
Practice Address - Country:US
Practice Address - Phone:843-693-2154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2502207P00000X
GA83775207P00000X
IN01057915A207P00000X, 2083A0100X
SC36547207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine