Provider Demographics
NPI:1881767382
Name:UNDERHILL, ERIK (MD)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:UNDERHILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 N VAN BUREN STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3851
Mailing Address - Country:US
Mailing Address - Phone:302-652-3771
Mailing Address - Fax:
Practice Address - Street 1:1806 N VAN BUREN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3851
Practice Address - Country:US
Practice Address - Phone:302-652-3771
Practice Address - Fax:302-652-3773
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006425207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000033583Medicaid
DE008802A40Medicare PIN
DEG91375Medicare UPIN