| Mapleton Medical Center, Inc. PC | |
|
101 E 34th St Indianapolis IN 46205-3408 | |
| (317) 924-4545 | |
| (317) 927-2167 |
| Full Name | Mapleton Medical Center, Inc. PC |
|---|---|
| Speciality | Family Medicine |
| Location | 101 E 34th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Debra a Carter-miller (PRES) |
| Authorized Official Contact | 3179244545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mapleton Medical Center, Inc. PC 101 E 34th St Indianapolis IN 46205-3408 Ph: (317) 924-4545 | Mapleton Medical Center, Inc. PC 101 E 34th St Indianapolis IN 46205-3408 Ph: (317) 924-4545 |
| NPI Number | 1942282603 |
|---|---|
| Provider Enumeration Date | 11/17/2005 |
| Last Update Date | 03/29/2021 |
| Certification Date | 03/29/2021 |
| Medicare PECOS PAC ID | 1355330184 |
|---|---|
| Medicare Enrollment ID | O20040507000856 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942282603 | NPI | - | NPPES |
| P00076736 | Other | IN | RR MEDICARE |
| 100121230A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Debra a Carter Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306828066 PECOS PAC ID: 7416946256 Enrollment ID: I20040507000890 |
| Provider Name | Kelly Patrice Patton-boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912531948 PECOS PAC ID: 0648705558 Enrollment ID: I20241130000053 |
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