MEDICARE: ROBERT C. ERICKSON M.D.

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
1	207W00000X	Ophthalmology Physician	RE058028	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F37296004	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	381867275	OTHER		HARRINGTON BENEFITS
3	381867275	OTHER		PPOM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	180F372960	OTHER	MI	BLUE CARE NETWORK
6	0F37296	OTHER	MI	BCBSM
7	381867275	OTHER		UNITED HEALTHCARE
8	G12736	OTHER		HAP
9	381867275	OTHER		AETNA
10	381867275	OTHER		CIGNA
11	381867275	OTHER		WPS TRICARE FOR LIFE
12	C5033	OTHER		MCARE
13	381867275	OTHER		GREAT LAKES

General Provider Information

NPI Number	:	1760476535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT C. ERICKSON M.D.

Provider Business Mailing Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-644-8060
Fax Number	:	248-644-5081

Provider Business Practice Location Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 201
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-644-8060
Fax Number	:	248-644-5081

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	03/02/2010

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