Provider Demographics
NPI:1326178971
Name:IMEL, ERIK ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:ALLEN
Last Name:IMEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:550 N MERIDIAN ST
Mailing Address - Street 2:STE 114
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1207
Mailing Address - Country:US
Mailing Address - Phone:317-274-3960
Mailing Address - Fax:317-274-5168
Practice Address - Street 1:550 UNIVERSITY BLVD
Practice Address - Street 2:STE 2180
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-944-7718
Practice Address - Fax:317-944-1289
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-02-08
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Provider Licenses
StateLicense IDTaxonomies
IN01057842A208000000X, 207R00000X
IN010578422080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200858580Medicaid
INI74246Medicare UPIN
INM400055784Medicare PIN
IN264910BHHHMedicare PIN