Individual
DEVIN ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMS, PA-C
Contact information
Practice address
7345 WATSON RD STE 203, SAINT LOUIS, MO 63119-9804
(314) 752-7100
(314) 525-4101
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 752-7100
(314) 525-4101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021008332
MO
363AM0700X
Medical Physician Assistant
2021008332
MO
Other
Enumeration date
04/25/2020
Last updated
06/25/2024
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