Individual
DR. ERIC EDWARD ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 281-6372
Mailing address
PO BOX 169, HARBERT, MI 49115-0169
(773) 255-7590
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
036090369
IL
2084P0800X
Psychiatry Physician
Primary
036090369
IL
2084P0800X
Psychiatry Physician
5101020205
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090369
—
IL
Enumeration date
11/09/2005
Last updated
11/17/2022
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