Healthcare Provider Details

I. General information

NPI: 1134137136
Provider Name (Legal Business Name): ERIK SIEVERTSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CLINTON ST
MUSKEGON MI
49443
US

IV. Provider business mailing address

PO BOX 1487
MUSKEGON MI
49443-1487
US

V. Phone/Fax

Practice location:
  • Phone: 231-728-4601
  • Fax:
Mailing address:
  • Phone: 616-975-1845
  • Fax: 616-975-1870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number86111
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301072224
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: