Doctor Name: | DR. ERIC EDWARD ERICKSON |
NPI Number: | 1558342220 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 036090369 |
Business Practice Address: | 300 68th St Se Grand Rapids, MI - 495486927 |
Business Phone Number: | 6162816372 |
Business Fax Number: | |
Mailing Address: | Po Box 169, HARBERT |
State: | MI |
Postal Code: | 491150169 |
Phone Number: | 7732557590 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 12/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 036090369 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |