MEDICARE: MAPLETON MEDICAL CENTER, INC. PC

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	207Q00000X	Family Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00076736	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942282603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAPLETON MEDICAL CENTER, INC. PC

Provider Business Mailing Address
First Line	:	101 E 34TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3408
Country	:	US
Telephone Number	:	317-924-4545
Fax Number	:	317-921-4024

Provider Business Practice Location Address
First Line	:	101 E 34TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-3408
Country	:	US
Telephone Number	:	317-924-4545
Fax Number	:	317-927-2167

Authorized Official
Title or Position	:	PRES
Name	:	DR. DEBRA A CARTER-MILLER
Credential	:	MD
Telephone Number	:	317-924-4545

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	03/29/2021

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