MEDICARE: DR. CARROL H ESTEP MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35038376E	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639134448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARROL H ESTEP MD

Provider Business Mailing Address
First Line	:	7700 WASHINGTON VILLAGE DR STE 260
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4097
Country	:	US
Telephone Number	:	937-435-9013
Fax Number	:	937-435-1458

Provider Business Practice Location Address
First Line	:	7700 WASHINGTON VILLAGE DR STE 160
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4094
Country	:	US
Telephone Number	:	937-435-9013
Fax Number	:	937-435-1458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	01/12/2021

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