Provider Demographics
NPI:1528189461
Name:MULDER, ERICA P (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:P
Last Name:MULDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:Z
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:402 N TEJON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1142
Mailing Address - Country:US
Mailing Address - Phone:719-633-3850
Mailing Address - Fax:719-227-0840
Practice Address - Street 1:402 N TEJON ST STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-1142
Practice Address - Country:US
Practice Address - Phone:719-633-3850
Practice Address - Fax:719-227-0840
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241183208000000X
CO46555208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics