MEDICARE: DR. PETER BLAKESLEE MAPES M.D., M.P.H. BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	4301052152	MI
2	208D00000X	General Practice Physician	4301052152	MI
3	2083A0100X	Aerospace Medicine Physician	4301052152	MI

General Provider Information

NPI Number	:	1437145133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER BLAKESLEE MAPES M.D., M.P.H. BS

Provider Business Mailing Address
First Line	:	206 EAST PARK STREET
Second Line	:
City	:	OSCODA
State	:	MI
Zip	:	48750-1645
Country	:	US
Telephone Number	:	937-212-8435
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 EAST PARK STREET
Second Line	:
City	:	OSCODA
State	:	MI
Zip	:	48750-1645
Country	:	US
Telephone Number	:	937-212-8435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	11/20/2019

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