Provider Demographics
NPI:1588650428
Name:MAURER, ERIK J (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:J
Last Name:MAURER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3650 PIPER ST
Mailing Address - Street 2:STE A
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4692
Mailing Address - Country:US
Mailing Address - Phone:907-339-9455
Mailing Address - Fax:907-339-9445
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4661
Practice Address - Country:US
Practice Address - Phone:907-907-3399
Practice Address - Fax:907-339-9445
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK44222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0011Medicaid
AKK151270Medicare ID - Type Unspecified
AKMD0011Medicaid