Individual
BERNARD RUDOLPH ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35376
MN
207RI0011X
Interventional Cardiology Physician
Primary
35376
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060046908
RR MEDICARE CU0204
—
01
—
1016077
PREFERRED ONE
—
01
—
106328
U-CARE
—
01
—
2114046
FIRST HEALTH PLAN
—
01
—
2500065
MEDICA HEALTH PLANS
—
01
—
42Q68ER
BLUE CROSS BLUE SHIELD
—
01
—
695582700
MEDICAL ASSISTANCE MA
—
05
—
695582700
—
MN
01
—
771742
ARAZ GROUP AMERICAS PPO
—
01
—
HP26067
HEALTH PARTNERS
—
Enumeration date
08/11/2005
Last updated
08/09/2012
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