Individual
DR. ERIK DMITRI BEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
129 HOSPITAL DR, WATERTOWN, WI 53098-3334
(920) 262-4800
(920) 262-4813
Mailing address
129 HOSPITAL DR, WATERTOWN, WI 53098-3334
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1882
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39649500
—
WI
Enumeration date
12/12/2005
Last updated
07/20/2010
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