Provider Demographics
NPI:1487604005
Name:MAIR, ERIC ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ALAN
Last Name:MAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2929 HEALTH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2762
Mailing Address - Country:US
Mailing Address - Phone:858-939-6621
Mailing Address - Fax:
Practice Address - Street 1:2929 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-939-6621
Practice Address - Fax:858-674-2348
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2006-00446207Y00000X
CAA49647207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3568454OtherCIGNA
SC000000262809OtherUNISON HEALTH PLAN SC
NC7627849OtherAETNA
SCN0044JMedicaid
NC189908OtherMEDCOST
NC1427UOtherBCBS NC
NC2153864OtherMAMSI
NC80388OtherCHCCARES OF SC
SC20092515OtherSELECT HEALTH OF SC
NC5779674OtherCOVENTRY HEALTHCARE
SC20092515OtherSELECT HEALTH OF SC