Healthcare Provider Details

I. General information

NPI: 1518192657
Provider Name (Legal Business Name): ERIN ZUSAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN CRIPE M.D.

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 11/27/2023
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 CLEARVISTA PARKWAY SUITE 290
INDIANAPOLIS IN
46256-5604
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-7780
  • Fax: 317-621-7783
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301093898
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01068200A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number01068200A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: