Provider Demographics
NPI:1013921709
Name:KNAPP, PETER M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:KNAPP
Suffix:JR
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 1:679 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1049
Mailing Address - Country:US
Mailing Address - Phone:317-807-1262
Mailing Address - Fax:317-859-4268
Practice Address - Street 1:12188A N MERIDIAN ST
Practice Address - Street 2:SUITE #200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4410
Practice Address - Country:US
Practice Address - Phone:317-564-5100
Practice Address - Fax:317-564-5556
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030554A207VF0040X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100194370OtherMEDICAID GROUP NUMBER
IN100238320Medicaid
IN000000091698OtherANTHEM PIN NUMBER
IN340012495OtherMEDICARE RAILROAD
IN340012527OtherMEDICARE RAILROAD
IN340012513OtherMEDICARE RAILROAD
IN1487680518OtherGROUP NPI
IN200288740OtherMEDICAID GROUP NUMBER
IN677730DMedicare PIN
IN345000AMedicare PIN
IN318870DMedicare PIN
IN200288740OtherMEDICAID GROUP NUMBER
IND70797Medicare UPIN
IN069350KMedicare PIN
IN677720DMedicare PIN