Provider Demographics
NPI:1598080327
Name:EBERT, ERIKA BETH (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:BETH
Last Name:EBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:BETH
Other - Last Name:STAGEBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-5000
Mailing Address - Fax:
Practice Address - Street 1:15 TRAFALGAR SQ STE 202
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1968
Practice Address - Country:US
Practice Address - Phone:603-883-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH162652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program