Provider Demographics
NPI:1346249000
Name:GRAPE, PETER A (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:GRAPE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1200
Mailing Address - Fax:781-340-1610
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1200
Practice Address - Fax:781-340-1610
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2015-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA46505207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA703699OtherTUFTS HEALTH PLAN
MA0036418OtherNEIGHBORHOOD HEALTH PLAN
MA49093OtherFALLON COMMUNITY HEALTH
MA6180191Medicaid
MAJ01041OtherBLUE CROSS BLUE SHIELD
MA3046OtherHARVARD PILGRIM
MA6180191Medicaid
MA0036418OtherNEIGHBORHOOD HEALTH PLAN