Erickson, Charles Burton

Erickson, Charles Burton is an individual health care provider with primary practice located at 530 3Rd St Nw Mail Stop 39400A, Elk River MN 55330-1445. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Erickson, Charles Burton can be contacted via phone (763) 712-6000.

Contact Information

Primary practice address
530 3Rd St Nw Mail Stop 39400A Elk River MN 55330-1445
Phone: (763) 712-6000
Fax: (763) 712-6591
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 23245 Minnesota

Profile Details

NPI number 1265409569
LBN Legal business name Erickson, Charles Burton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2006
Last updated May 18th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265409569 NPPES
Minnesota MEDICAID 451592700

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