Provider Demographics
NPI:1699284919
Name:MCGILLIS, ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:MCGILLIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:REGIONS HOSPITAL - EMERGENCY MEDICINE, 11102F
Mailing Address - Street 2:640 JACKSON ST
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101
Mailing Address - Country:US
Mailing Address - Phone:651-254-5298
Mailing Address - Fax:651-254-5216
Practice Address - Street 1:REGIONS HOSPITAL - EMERGENCY MEDICINE, 11102F
Practice Address - Street 2:640 JACKSON ST
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101
Practice Address - Country:US
Practice Address - Phone:651-254-5298
Practice Address - Fax:651-254-5216
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN62376207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology