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Individual

DR. CHARLES G ERICKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1021 N 27TH ST, LINCOLN, NE 68503-1803
(402) 476-1455
(402) 476-1655
Mailing address
7208 SUGAR CREEK CIR, LINCOLN, NE 68516-5634
(402) 420-3088

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
11074
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11074
STATE LICENSE NUMBER
NE
Enumeration date
04/19/2007
Last updated
07/13/2012
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