Provider Demographics
NPI:1942282603
Name:MAPLETON MEDICAL CENTER, INC. PC
Entity Type:Organization
Organization Name:MAPLETON MEDICAL CENTER, INC. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTER-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-924-4545
Mailing Address - Street 1:101 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3408
Mailing Address - Country:US
Mailing Address - Phone:317-924-4545
Mailing Address - Fax:317-921-4024
Practice Address - Street 1:101 E 34TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3408
Practice Address - Country:US
Practice Address - Phone:317-924-4545
Practice Address - Fax:317-927-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00076736OtherRR MEDICARE
IN100121230AMedicaid
IN100121230AMedicaid