Basic Information
Provider Information
NPI: 1164861399
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBERTS
FirstName: ERIKA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BRAMLETT
OtherFirstName: ERIKA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 3060 TOWERING OAKS DR
Address2:  
City: WHITE LAKE
State: MI
PostalCode: 483833420
CountryCode: US
TelephoneNumber: 7343017944
FaxNumber:  
Practice Location
Address1: 1 GENESYS PKWY
Address2:  
City: GRAND BLANC
State: MI
PostalCode: 484398065
CountryCode: US
TelephoneNumber: 8106065000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/20/2013
LastUpdateDate: 11/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X4301103686MIY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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