MEDICARE: DR. ERIC DAVID KNAPP D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QB0002X	Obesity Medicine (Family Medicine) Physician	02003840A	IN
2	208600000X	Surgery Physician	02003840A	IN

General Provider Information

NPI Number	:	1700090602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC DAVID KNAPP D.O.

Provider Business Mailing Address
First Line	:	5215 HOLY CROSS PKWY
Second Line	:	PROVIDER SERVICES-ENROLLMENT
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 E DOUGLAS RD STE 207
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1465
Country	:	US
Telephone Number	:	574-335-6850
Fax Number	:	574-335-0849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	05/21/2026

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