Provider Demographics
NPI:1558410100
Name:SEAS, ERICA L (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:SEAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:L
Other - Last Name:PETERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2019 BROADWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4810
Mailing Address - Country:US
Mailing Address - Phone:406-237-5200
Mailing Address - Fax:406-237-5205
Practice Address - Street 1:2019 BROADWATER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4810
Practice Address - Country:US
Practice Address - Phone:406-237-5200
Practice Address - Fax:406-237-5205
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10004207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTH87221Medicare UPIN