Individual
MR. ROBERT D DOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
(765) 448-7619
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343297
ANTHEM PIN NUMBER
IN
01
—
000000640746
ANTHEM PROVIDER NUMBER
IN
Enumeration date
08/01/2006
Last updated
02/02/2021
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