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ERIC E. PETTERSON P.C.
NPI 1518417690
Internal Medicine - Addiction Medicine in Shenandoah, PA

Active since October 12, 2016
1 S MAIN ST, SHENANDOAH, PA 17976(570) 861-0802(570) 462-1040 Get Directions Write a Review

NPPES record last updated: November 11, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Nov 11, 2023, Jun 11, 2019, Jun 16, 2018 and 2 more (5 updates tracked since 2016).

About Eric E. Petterson P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERIC E. PETTERSON P.C. (NPI 1518417690) is a healthcare organization registered as an addiction medicine in Shenandoah, Pennsylvania and active in the NPI registry since October 2016. The organization lists Eric Evan Petterson, President, as its authorized official.

NPPES Registry Identity

NPI1518417690
Entity TypeOrganization
Primary Taxonomy207RA0401X
Legal Business NameERIC E. PETTERSON P.C.
Location Address1 S MAIN STShenandoah, PA 17976
Mailing Address1 S Main StShenandoah, PA 17976-2332 · (570) 861-0802 · Fax (570) 462-1040
Phone(570) 861-0802
Fax(570) 462-1040
Organization SubpartNo
Authorized OfficialEric Evan PettersonPresident · (570) 462-1040
Enumeration DateOctober 12, 2016
Last NPPES UpdateNovember 11, 20235 updates tracked since enumeration
NPPES CertifiedNovember 11, 2023
✔ NPI 1518417690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RA0401X
License✔ Licensed in PA · MD039636L
Definition
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.
1 S MAIN ST, Shenandoah, PA 17976
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Other Identifiers 1

Medicaid0010036980010PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eric E. Petterson P.C.'s NPI number?

The NPI number for Eric E. Petterson P.C. is 1518417690. It was assigned to this organization in the NPPES registry on October 12, 2016.

Where is Eric E. Petterson P.C. located?

Eric E. Petterson P.C. is located at 1 S Main St, Shenandoah, PA 17976. The listed phone number is (570) 861-0802.

What is Eric E. Petterson P.C.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.

When was this NPI record last updated?

The NPPES record for Eric E. Petterson P.C. was last updated on November 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.