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Individual

ERIC A POULIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
132 17TH AVE NW, ROCHESTER, MN 55901-0321
(507) 292-7411
Mailing address
132 17TH AVE NW, ROCHESTER, MN 55901-0321
(507) 292-7411

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41049
MN
207Q00000X
Family Medicine Physician
41803020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32549800
WI
Enumeration date
08/30/2005
Last updated
04/23/2024
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