Individual
MR. ERIK C RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4300 MARKET PTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 767-4574
(952) 835-4403
Mailing address
4300 MARKET PTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 767-4574
(952) 835-4403
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9272
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982670758
MEDICA
MN
01
—
73L03RI
BLUE CROSS BLUE SHIELD MN
MN
05
—
908143700
—
MN
01
—
NA9091021565
PREFERRED ONE
MN
Enumeration date
02/23/2006
Last updated
09/19/2023
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