| Peter V. Madill, M.d. A Medical Corporation | |
|
1020 Gravenstein Hwy. So. Suite 120 Sebastopol CA 95472-4569 | |
| (707) 823-3312 | |
| (707) 823-4901 |
| Full Name | Peter V. Madill, M.d. A Medical Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1020 Gravenstein Hwy. So., Sebastopol, California |
| Authorized Official Name and Position | Peter Vokes Madill (PRESIDENT) |
| Authorized Official Contact | 7078233312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter V. Madill, M.d. A Medical Corporation 1020 Gravenstein Hwy. So. Suite 120 Sebastopol CA 95472-4569 Ph: (707) 823-3312 | Peter V. Madill, M.d. A Medical Corporation 1020 Gravenstein Hwy. So. Suite 120 Sebastopol CA 95472-4569 Ph: (707) 823-3312 |
| NPI Number | 1134133085 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3274725155 |
|---|---|
| Medicare Enrollment ID | O20101029000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134133085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A31200 (California) | Primary |
| Provider Name | Peter Madill |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215941141 PECOS PAC ID: 7719179696 Enrollment ID: I20101011000590 |
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