Provider Demographics
NPI:1902363401
Name:DONALD, ERIC (PHD CANDIDATE)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:DONALD
Suffix:
Gender:M
Credentials:PHD CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28945 BIRCHLAWN ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2426
Mailing Address - Country:US
Mailing Address - Phone:734-772-4009
Mailing Address - Fax:
Practice Address - Street 1:28945 BIRCHLAWN ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2426
Practice Address - Country:US
Practice Address - Phone:734-772-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician