Individual
DANIEL WILSON ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 N SENATE BLVD, ROOM AG-012, INDIANAPOLIS, IN 46202-1239
(317) 962-3525
(317) 963-5394
Mailing address
10410 FOREST CREEK DR, INDIANAPOLIS, IN 46239-9532
(317) 965-3541
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075355A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017608A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201233550
—
IN
Enumeration date
05/29/2014
Last updated
07/07/2015
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