Healthcare Provider Details

I. General information

NPI: 1396488490
Provider Name (Legal Business Name): ERIK KEITH HUNSAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 SUGAR MAPLE DR BLDG 830
WPAFB OH
45433-5529
US

IV. Provider business mailing address

4881 SUGAR MAPLE DR BLDG 830
WPAFB OH
45433-5529
US

V. Phone/Fax

Practice location:
  • Phone: 937-257-6877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36248
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: