Provider Demographics
NPI:1487396685
Name:HALPERT, ERIC MICHAEL
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MICHAEL
Last Name:HALPERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC BOX 20180
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28542-0180
Mailing Address - Country:US
Mailing Address - Phone:804-926-0964
Mailing Address - Fax:
Practice Address - Street 1:H M SMITH BLVVD
Practice Address - Street 2:
Practice Address - City:CAMP LEJUNE
Practice Address - State:NC
Practice Address - Zip Code:28547
Practice Address - Country:US
Practice Address - Phone:804-926-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman