Provider Demographics
NPI:1669424891
Name:MONESMITH, ERIC A (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:MONESMITH
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 1:8450 NORTHWEST BLVD.
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1381
Mailing Address - Country:US
Mailing Address - Phone:317-802-2000
Mailing Address - Fax:317-802-2170
Practice Address - Street 1:1260 INNOVATION PKWY #100
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3602
Practice Address - Country:US
Practice Address - Phone:317-884-5200
Practice Address - Fax:317-884-5360
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050783207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200171900Medicaid
IN200171900Medicaid
IN200171900Medicaid