Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 62266 | MN |
NPI | 1023438876 |
---|---|
Provider Name | Eric Christopher Stone |
First Address | Rochester, MN 55905-1029 |
Second Address | Rochester, MN 55905-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2014 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ES3232267556 | (05) | CA |