Provider Demographics
NPI:1659705648
Name:DICHARI, ERYN (MD)
Entity Type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:DICHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERYN
Other - Middle Name:
Other - Last Name:STUBBLEFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1194
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-1194
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:981150 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3011
Practice Address - Country:US
Practice Address - Phone:402-559-6802
Practice Address - Fax:402-559-9659
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD198091207P00000X
NE8071207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program