Beaver, Erik Dmitri
Beaver, Erik Dmitri is an individual health care provider with primary practice located at 129 Hospital Dr , Watertown WI 53098-3334. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Beaver, Erik Dmitri can be contacted via phone (920) 262-4800.Contact Information
Primary practice address
129 Hospital Dr
Watertown WI 53098-3334
Phone: (920) 262-4800
Fax: (920) 262-4813
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1882 | Wisconsin |
Profile Details
| NPI number | 1881679975 |
|---|---|
| LBN Legal business name | Beaver, Erik Dmitri |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2005 |
| Last updated | Jul 20th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881679975 | NPPES |
| Wisconsin | MEDICAID | 39649500 |
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