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General NPI Number Information
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NPI Number | 1366488587
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Entity Type | Individual
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Provider Name | ERIC SAGE SALMAN P.A.C
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 1835 COUNTY ROAD C W STE 150
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City | ROSEVILLE
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State | MN
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Zip | 55113-1343
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Country | US
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Telephone | 651-430-3800
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Fax | 651-430-3827
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Provider Business Mailing Address
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Address Line | 1950 NORTHWESTERN AVE S STE 102
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City | STILLWATER
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State | MN
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Zip | 55082-7615
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Country | US
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Telephone | 651-430-3800
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Fax | 651-241-7272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 00062701
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 00062924
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License Number State | MN
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