Provider Demographics
NPI:1699785451
Name:OLIET, ERIC J (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:OLIET
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 1:800 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1322
Mailing Address - Country:US
Mailing Address - Phone:302-655-9656
Mailing Address - Fax:302-655-9602
Practice Address - Street 1:800 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1322
Practice Address - Country:US
Practice Address - Phone:302-655-9656
Practice Address - Fax:302-655-9602
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI0002256207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE510273648OtherBC/BS PROV #
DE070001368Medicare PIN
DE510273648OtherBC/BS PROV #
DEB66613Medicare UPIN