Provider Demographics
NPI:1780730242
Name:JOSEPH, ERICA TOBIN (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:TOBIN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:DEE
Other - Last Name:TOBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15310 CAMBERLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:301-801-9204
Mailing Address - Fax:
Practice Address - Street 1:5401 OLD COURT RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5103
Practice Address - Country:US
Practice Address - Phone:410-521-5950
Practice Address - Fax:410-521-5942
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052760207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG88342Medicare UPIN