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Individual

MR. MATTHEW C ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.-C

Contact information

Practice address
8740 RIVERS AVE, N CHARLESTON, SC 29406-9211
(843) 572-5990
Mailing address
8740 RIVERS AVE, NORTH CHARLESTON, SC 29406-9211
(843) 572-5990
(843) 572-2928

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1800
SC
363AM0700X
Medical Physician Assistant
1800
SC
363AS0400X
Surgical Physician Assistant
085004143
IL

Other

Enumeration date
09/26/2011
Last updated
12/01/2015
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