Individual
CHARLES BURTON ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 3RD ST NW, MAIL STOP 39400A, ELK RIVER, MN 55330-1445
(763) 712-6000
(763) 712-6591
Mailing address
8100 34TH AVE S, 21110Q, BLOOMINGTON, MN 55425-1672
(952) 883-5790
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23245
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
451592700
—
MN
Enumeration date
03/06/2006
Last updated
05/18/2015
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