Provider Demographics
NPI:1437318706
Name:TOLLIVER, ABBIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:M
Last Name:TOLLIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:M
Other - Last Name:BERRYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8607 E US HIGHWAY 36 STE 100
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-7960
Mailing Address - Country:US
Mailing Address - Phone:317-745-5403
Mailing Address - Fax:
Practice Address - Street 1:8607 E US HIGHWAY 36 STE 100
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7960
Practice Address - Country:US
Practice Address - Phone:317-745-5403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065136A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine