Individual
DR. LOREN ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 UNIVERSITY AVE W, SUITE 19-C, SAINT PAUL, MN 55104-3898
(651) 646-7084
Mailing address
1600 UNIVERSITY AVE W, SUITE 19-C, SAINT PAUL, MN 55104-3898
(651) 646-7084
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
113462
MN
213E00000X
Podiatrist
444
MN
213E00000X
Podiatrist
759
MO
213EP1101X
Primary Podiatric Medicine Podiatrist
444
MN
213ES0000X
Sports Medicine Podiatrist
444
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
444
MN
213ES0103X
Foot & Ankle Surgery Podiatrist
759
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
564025300
—
MN
Enumeration date
03/16/2006
Last updated
11/14/2011
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