Provider Demographics
NPI:1255607347
Name:CULBERT, ERIN L (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:L
Last Name:CULBERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4536
Mailing Address - Country:US
Mailing Address - Phone:203-863-3671
Mailing Address - Fax:203-863-4758
Practice Address - Street 1:2015 W MAIN ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4536
Practice Address - Country:US
Practice Address - Phone:203-863-3671
Practice Address - Fax:203-863-4758
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT053736207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine