Provider Demographics
NPI:1538480082
Name:FISK, ERICA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:ELIZABETH
Last Name:FISK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:ELIZABETH
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8450 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1381
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:317-802-2170
Practice Address - Street 1:10995 ALLISONVILLE RD STE 102
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2617
Practice Address - Country:US
Practice Address - Phone:317-915-8110
Practice Address - Fax:317-915-8120
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01084797A207X00000X, 207XX0004X, 207XX0004X
CAA144531207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA144531OtherSTATE LICENSE
CACA218893OtherMEDICARE PTAN