Individual
DR. DARREN ROBERT DOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 LAWN AVE STE 100, ELKHART, IN 46514-2493
(574) 293-2893
(574) 293-1298
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01074203A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201254340
—
IN
01
—
23604010
MEDICARE PTAN
IN
01
—
565800013
MEDICARE PTAN
IN
Enumeration date
06/08/2010
Last updated
01/07/2022
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