Provider Demographics
NPI:1639277460
Name:ALPERT, ERYN (MD)
Entity Type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:ALPERT
Suffix:
Gender:F
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:PO BOX 23321
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-3321
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:1810 US HWY 321 BYPASS S
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-7127
Practice Address - Country:US
Practice Address - Phone:803-365-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006012789207P00000X
MO2003012621207P00000X
SC83942207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0225070OtherLIWA
WA1479ALOtherBSWA
WA8494379Medicaid
WA0225071OtherBSWA
MO201187002Medicaid
WA2264ALOtherBSWA
WAG8868243Medicare PIN
WA2264ALOtherBSWA
MO201187002Medicaid
WAG8868242Medicare PIN