Provider Demographics
NPI:1588805725
Name:WINDSOR, ERIC (MAC, LAC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:WINDSOR
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SPRING ST STE G5
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4028
Mailing Address - Country:US
Mailing Address - Phone:301-588-5858
Mailing Address - Fax:
Practice Address - Street 1:1111 SPRING ST STE G5
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4028
Practice Address - Country:US
Practice Address - Phone:301-588-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01727171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist