Individual
DR. ELMER TOLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-3834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01050450A
IN
207P00000X
Emergency Medicine Physician
036-091058
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091058
—
IL
05
—
200446460
—
IN
Enumeration date
12/27/2005
Last updated
08/30/2021
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