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NPI Code Detail

MEDICARE: ERIK WILSON

MEDICARE: ERIK WILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist2790MN

General Provider Information

NPI Number : 1356855399
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIK WILSON
Provider Business Mailing Address
First Line : 1301 MILLER TRUNK HWY STE 500
Second Line :
City : DULUTH
State : MN
Zip : 55811-5644
Country : US
Telephone Number : 218-720-3787
Fax Number :
Provider Business Practice Location Address
First Line : 1301 MILLER TRUNK HWY STE 500
Second Line :
City : DULUTH
State : MN
Zip : 55811-5644
Country : US
Telephone Number : 218-720-3787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2017
Last Update Date : 11/29/2017

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Directions to “ ERIK WILSON ” Practice Location

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