Provider Demographics
NPI:1447660964
Name:HODGES, ERIN LANDIS (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LANDIS
Last Name:HODGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 FAIRVIEW RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3113
Mailing Address - Country:US
Mailing Address - Phone:704-495-6334
Mailing Address - Fax:
Practice Address - Street 1:201 S COLLEGE ST FL 12
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28244-0002
Practice Address - Country:US
Practice Address - Phone:704-489-3010
Practice Address - Fax:980-949-6769
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-02501207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1447660964Medicaid