Provider Demographics
NPI:1972563153
Name:VILJOEN, ERIKA (MD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:VILJOEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:VAN WYK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6900 VAN DORN ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2882
Mailing Address - Country:US
Mailing Address - Phone:402-489-3200
Mailing Address - Fax:402-489-5101
Practice Address - Street 1:6900 VAN DORN ST
Practice Address - Street 2:SUITE 24
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2882
Practice Address - Country:US
Practice Address - Phone:402-489-3200
Practice Address - Fax:402-489-5101
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20489207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE080115471OtherRAILROAD MEDICARE
NE47052866513Medicaid
269078Medicare ID - Type Unspecified
G75248Medicare UPIN