Provider Demographics
NPI:1932337011
Name:MIKAITIS, ERIK P (MD)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:P
Last Name:MIKAITIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10206 CHERRYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-5126
Mailing Address - Country:US
Mailing Address - Phone:772-256-9374
Mailing Address - Fax:
Practice Address - Street 1:10206 CHERRYWOOD LN
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-5126
Practice Address - Country:US
Practice Address - Phone:772-256-9374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125057148207R00000X
IN01071032A207R00000X, 207RH0002X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000773147OtherANTHEM
IN201077670Medicaid
IN000000773147OtherANTHEM