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General NPI Number Information
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NPI Number | 1750601175
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Entity Type | Individual
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Provider Name | DARREN ROBERT DOLLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 1215 LAWN AVE STE 100
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City | ELKHART
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State | IN
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Zip | 46514-2493
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Country | US
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Telephone | 574-293-2893
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Fax | 574-293-1298
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Provider Business Mailing Address
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Address Line | 710 N NILES AVE
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City | SOUTH BEND
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State | IN
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Zip | 46617-1924
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Country | US
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Telephone | 574-647-1610
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Fax | 574-237-6069
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01074203A
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License Number State | IN
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