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General NPI Number Information
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NPI Number | 1508044678
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Entity Type | Individual
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Provider Name | DIANE ELIZABETH ELROD D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 3266 N MERIDIAN STREET STE 101
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5859
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Country | US
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Telephone | 317-925-0653
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Fax | 317-925-0774
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Provider Business Mailing Address
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Address Line | 3266 N MERIDIAN STREET STE 101
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5859
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Country | US
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Telephone | 317-925-0653
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Fax | 317-925-0774
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02001479A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 02001479A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 02001479A
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License Number State | IN
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