Individual
KEVIN R ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 E DOUGLAS RD, STE 407, MISHAWAKA, IN 46545-1464
(574) 335-6500
(574) 335-0772
Mailing address
611 E DOUGLAS RD STE 407, MISHAWAKA, IN 46545-1468
(574) 335-6500
(574) 335-0772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01046492
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200142060A
MEDICAID
IN
Enumeration date
07/15/2006
Last updated
01/13/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us