MEDICARE: ASHLIE OLP 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	01053050A	IN

General Provider Information

NPI Number	:	1912903915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLIE OLP MD

Provider Business Mailing Address
First Line	:	9002 N MERIDIAN ST
Second Line	:	STE 107
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-5349
Country	:	US
Telephone Number	:	317-848-7970
Fax Number	:

Provider Business Practice Location Address
First Line	:	9002 N MERIDIAN ST
Second Line	:	STE 107
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-5349
Country	:	US
Telephone Number	:	317-848-7970
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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Directions to “ ASHLIE OLP MD” Practice Location

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