Provider Demographics
NPI:1467472753
Name:EPPLER, EDWIN M (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:M
Last Name:EPPLER
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:SUITE 130 - PROVIDER ENROLLEMENT
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:260-407-8000
Mailing Address - Fax:317-962-4343
Practice Address - Street 1:1542 S BLOOMINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-2297
Practice Address - Country:US
Practice Address - Phone:765-301-7617
Practice Address - Fax:765-301-7621
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01045296A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200112140Medicaid
I29602Medicare UPIN
IN131180XXXMedicare PIN
IN200112140Medicaid