Provider Demographics
NPI:1548219306
Name:LEVERENTZ, ERIN G (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:G
Last Name:LEVERENTZ
Suffix:
Gender:F
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6533 DREW AVENUE SOUTH
Mailing Address - Street 2:OPHTHALMOLOGY ASSOCIATES
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2103
Mailing Address - Country:US
Mailing Address - Phone:952-925-9550
Mailing Address - Fax:
Practice Address - Street 1:6533 DREW AVE. SOUTH
Practice Address - Street 2:OPHTHALMOLOGY ASSOCIATES
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55435-2103
Practice Address - Country:US
Practice Address - Phone:952-925-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI595-TEP207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology