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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245278183 NPPES
Alaska MEDICAID MD45932

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