Healthcare Provider Details

I. General information

NPI: 1326178971
Provider Name (Legal Business Name): ERIK ALLEN IMEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 UNIVERSITY BLVD STE 2180
INDIANAPOLIS IN
46202-5149
US

IV. Provider business mailing address

550 N MERIDIAN ST STE 114
INDIANAPOLIS IN
46204-1207
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-7718
  • Fax: 317-944-1289
Mailing address:
  • Phone: 317-274-3960
  • Fax: 317-274-5168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01057842A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number01057842A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01057842A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number01057842
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number01057842A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: