Provider Demographics
NPI:1982683876
Name:UMALI, ERIC FILEMON (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:FILEMON
Last Name:UMALI
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 1:5361 N BENSON RD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49410-8713
Mailing Address - Country:US
Mailing Address - Phone:616-813-1346
Mailing Address - Fax:
Practice Address - Street 1:5165 MCCARTY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-8764
Practice Address - Country:US
Practice Address - Phone:765-448-8000
Practice Address - Fax:765-838-4758
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101286611207L00000X
MI4301060283207L00000X
WAMD61489808207L00000X
IN01093603A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3514517Medicaid
M71590038Medicare ID - Type Unspecified
G30177Medicare UPIN