Provider Demographics
NPI:1568508307
Name:ERICKSON, MATTHEW GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GEORGE
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 414
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3700
Mailing Address - Country:US
Mailing Address - Phone:608-848-7571
Mailing Address - Fax:
Practice Address - Street 1:2701 UNIVERSITY AVE
Practice Address - Street 2:SUITE 414
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3700
Practice Address - Country:US
Practice Address - Phone:608-848-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39573207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease