Individual
THOMAS DASCOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6920 PARKDALE PLACE, SUITE 106, INDIANAPOLIS, IN 46254-5604
(317) 329-7400
(317) 329-7447
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01024866
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100356280
—
IN
Enumeration date
06/09/2006
Last updated
01/29/2014
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