Provider Demographics
NPI:1467451419
Name:MAPLES, MICHAEL W (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:MAPLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3550
Mailing Address - Country:US
Mailing Address - Phone:509-574-6117
Mailing Address - Fax:509-573-6275
Practice Address - Street 1:501 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-3550
Practice Address - Country:US
Practice Address - Phone:509-494-6700
Practice Address - Fax:509-573-6275
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8932820OtherCRIME VICTIM
WA8545204Medicaid
WA0031695OtherLABOR & INDUSTRIES
WAP00050801OtherRAILROAD MEDICARE
WAA06866Medicare UPIN
WA8545204Medicaid
WAP00050801OtherRAILROAD MEDICARE