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Individual

ERIC TRIPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5215 HOLY CROSS PARKWAY, MISHAWAKA, IN 46545
(574) 335-5000
(574) 335-0760
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8172
(269) 985-4535

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01040707
IN
208M00000X
Hospitalist Physician
Primary
4301102003
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000334836
BCBS
IN
01
000000687861
BCBS
IN
05
100328400
IN
05
100328400H
IN
Enumeration date
06/12/2006
Last updated
01/23/2018
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