Provider Demographics
NPI:1033267182
Name:MAGERS, ERICA (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MAGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-3500
Mailing Address - Fax:208-625-3501
Practice Address - Street 1:914 W IRONWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4927
Practice Address - Country:US
Practice Address - Phone:208-625-3500
Practice Address - Fax:208-625-3501
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMC0953207Q00000X
MIEM082598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00382975OtherRAILROAD MEDICARE
MI104954493Medicaid
MI200000007190OtherPHPMM
MI0802310322OtherBCBS
MI104954493Medicaid
MIM32520019Medicare PIN