Individual
ERIK A SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 65TH AVENUE, OSCEOLA, WI 54020-3024
(715) 294-2111
(715) 294-5758
Mailing address
PO BOX 218, 2600 65TH AVENUE, OSCEOLA, WI 54020-3024
(715) 294-2111
(715) 294-2111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40815
WI
207Q00000X
Family Medicine Physician
47722
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34682800
—
WI
01
—
47722
MEDICAL LICENSE
WI
Enumeration date
09/05/2006
Last updated
10/21/2010
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