Healthcare Provider Details

I. General information

NPI: 1205151628
Provider Name (Legal Business Name): ERICA ANSPACH WILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA ANSPACH WILL MD

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12188A N MERIDIAN ST STE 250
CARMEL IN
46032-4426
US

IV. Provider business mailing address

PO BOX 772437
DETROIT MI
48277-2437
US

V. Phone/Fax

Practice location:
  • Phone: 317-571-1637
  • Fax: 317-571-2238
Mailing address:
  • Phone: 317-575-7304
  • Fax: 317-575-7333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number01077530A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: