Individual
ERIK A LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1850 TOWN CENTER PARKWAY, SUITE 400, RESTON, VA 20190
(703) 810-5202
(703) 787-9664
Mailing address
PO BOX 60318, CHARLOTTE, NC 28260-0318
(703) 383-6469
(703) 385-0575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001633
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00071404
MEDICARE RAILROAD
—
Enumeration date
07/21/2006
Last updated
04/27/2009
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