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Individual

MICHAEL ALAN ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 751-5430
Mailing address
1386 SUMMER CT NW, BEMIDJI, MN 56601-9747
(218) 591-1129

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R-180394-7
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
100366
MN

Other

Enumeration date
12/03/2013
Last updated
12/19/2013
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