Individual
ERIC W LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6525 DREW AVE S, EDINA, MN 55435
(952) 920-6748
(952) 920-3863
Mailing address
6525 DREW AVE S, EDINA, MN 55435
(952) 920-6748
(952) 920-3863
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28533
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131L0LA
BCBS MN
MN
01
—
172494
UCARE
MN
05
—
792325200
—
MN
Enumeration date
10/02/2006
Last updated
07/08/2007
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