Provider Demographics
NPI:1497717243
Name:RIPLEY, PETER M (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:RIPLEY
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 1:23 WHITES PATH STE F
Mailing Address - Street 2:
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-1238
Mailing Address - Country:US
Mailing Address - Phone:508-760-2054
Mailing Address - Fax:508-760-1218
Practice Address - Street 1:23 WHITES PATH
Practice Address - Street 2:SUITE F
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1221
Practice Address - Country:US
Practice Address - Phone:508-760-2054
Practice Address - Fax:508-760-1218
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3019853Medicaid
MAJ06168Medicare ID - Type Unspecified
MA3019853Medicaid