Provider Demographics
NPI:1174940340
Name:PUSTER, ERIC (DO)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:PUSTER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6940 MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2800
Mailing Address - Country:US
Mailing Address - Phone:317-266-2901
Mailing Address - Fax:317-266-2912
Practice Address - Street 1:6940 MICHIGAN RD
Practice Address - Street 2:STE 140
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2800
Practice Address - Country:US
Practice Address - Phone:317-266-2901
Practice Address - Fax:317-266-2916
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN02004879A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program