Provider Demographics
NPI:1265607253
Name:CHEESEMAN, ERIC DAVID (RT, RDCS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DAVID
Last Name:CHEESEMAN
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Gender:M
Credentials:RT, RDCS
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Mailing Address - Street 1:88 JIMMY GREEN RD
Mailing Address - Street 2:
Mailing Address - City:EAST HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59635-3461
Mailing Address - Country:US
Mailing Address - Phone:406-868-3246
Mailing Address - Fax:406-868-3246
Practice Address - Street 1:88 JIMMY GREEN RD
Practice Address - Street 2:
Practice Address - City:EAST HELENA
Practice Address - State:MT
Practice Address - Zip Code:59635-3461
Practice Address - Country:US
Practice Address - Phone:406-868-3246
Practice Address - Fax:406-868-3246
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000082472Medicare PIN