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Individual

DR. JOHN K ERIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4472
SD
207L00000X
Anesthesiology Physician
Primary
6387
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005830
BLUE CROSS SD
SD
05
179503100
MN
05
511493
IA
01
56P30ER
BLUE CROSS MN
MN
05
5700110
SD
05
713966
ND
Enumeration date
06/07/2006
Last updated
04/25/2012
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