Erickson, Wade
Erickson, Wade is an sole proprietor health care provider with primary practice located at 3066 E Meridian Park Loop , Wasilla AK 99654-7299. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Pharmacy Service Providers / Pharmacist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Erickson, Wade can be contacted via phone (907) 357-9593.Contact Information
Primary practice address
3066 E Meridian Park Loop
Wasilla AK 99654-7299
Phone: (907) 357-9593
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4593 | Alaska |
| Pharmacy Service Providers / Pharmacist | 183500000X | 4593 | Alaska |
Profile Details
| NPI number | 1245278183 |
|---|---|
| LBN Legal business name | Erickson, Wade |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 3rd, 2006 |
| Last updated | Oct 11th, 2011 - about 13 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 | 1245278183 | NPPES |
| Alaska | MEDICAID | MD45932 |
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