Dr Darren Robert Dolly, MD | |
1215 Lawn Ave Ste 100, Elkhart, IN 46514-2493 | |
(574) 293-2893 | |
(574) 293-1298 |
Full Name | Dr Darren Robert Dolly |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 1215 Lawn Ave Ste 100, Elkhart, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750601175 | NPI | - | NPPES |
23604010 | Other | IN | MEDICARE PTAN |
201254340 | Medicaid | IN | |
565800013 | Other | IN | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 01074203A (Indiana) | Primary |
Entity Name | The Southeast Permanente Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
---|---|
Dr Darren Robert Dolly, MD 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610 | Dr Darren Robert Dolly, MD 1215 Lawn Ave Ste 100, Elkhart, IN 46514-2493 Ph: (574) 293-2893 |
Enrique Eduardo Infante, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1215 Lawn Ave, Suite 100, Elkhart, IN 46514 Phone: 574-293-2893 Fax: 574-293-1298 | |
Dr. Thalia Raya Pachiyannakis, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1545 Cassopolis St, Elkhart, IN 46514 Phone: 574-584-2501 | |
Dr. Rosalie L Mcbride, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2405 W Lexington Ave, Elkhart, IN 46514 Phone: 574-524-7575 Fax: 574-524-7576 | |
Martina A Green-mcgowan, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052 Fax: 574-293-3744 | |
Jeffrey L. Cain, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 3301 County Road 6 E, Elkhart, IN 46514 Phone: 574-264-9635 | |
Dr. Starla D Graber, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2405 West Lexington Avenue, Elkhart, IN 46514 Phone: 574-524-7575 Fax: 574-524-7576 | |
Kathrin Marie Parisi, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1215 Lawn Ave Ste 110, Elkhart, IN 46514 Phone: 574-524-7570 Fax: 574-524-7571 |