Provider Demographics
NPI:1982601324
Name:USIS, ERIKS A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIKS
Middle Name:A
Last Name:USIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 MENTOR AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4496
Mailing Address - Country:US
Mailing Address - Phone:440-974-4470
Mailing Address - Fax:440-974-4173
Practice Address - Street 1:9000 MENTOR AVE STE 100
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4496
Practice Address - Country:US
Practice Address - Phone:440-974-4470
Practice Address - Fax:440-974-4173
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074903U208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2221269Medicaid