Healthcare Provider Details

I. General information

NPI: 1851438816
Provider Name (Legal Business Name): TOLLY ELIZABETH EPSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOLLY ELIZABETH GOLDBERG-EPSTEIN M.D.

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9002 N MERIDIAN ST STE 107
INDIANAPOLIS IN
46260-5349
US

IV. Provider business mailing address

PO BOX 603725
CHARLOTTE NC
28260-3725
US

V. Phone/Fax

Practice location:
  • Phone: 317-848-9441
  • Fax: 317-924-8239
Mailing address:
  • Phone: 828-575-2663
  • Fax: 828-350-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number01072065A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: