Healthcare Provider Details

I. General information

NPI: 1376255521
Provider Name (Legal Business Name): MR. ERIK MARK STERLING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2022
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WELLS ST
WESTERLY RI
02891-2934
US

IV. Provider business mailing address

746 MIDDLEBRIDGE RD
WAKEFIELD RI
02879-7144
US

V. Phone/Fax

Practice location:
  • Phone: 401-596-6000
  • Fax:
Mailing address:
  • Phone: 401-829-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01578
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: