Provider Demographics
NPI:1699781369
Name:SHIRLEY, ERIC ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANDREW
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:VA MEDICAL CTR
Mailing Address - Street 2:215 NORTH MAIN STREET
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05009-0001
Mailing Address - Country:US
Mailing Address - Phone:802-295-9363
Mailing Address - Fax:802-291-6240
Practice Address - Street 1:VAMEDICAL CTR
Practice Address - Street 2:215 NORTH MAIN STREET
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:802-291-6240
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0006412207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine