MEDICARE: PETER J KAPLAN MD

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	174400000X	Specialist	54247	GA
2	207R00000X	Internal Medicine Physician	54247	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1942203757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J KAPLAN MD

Provider Business Mailing Address
First Line	:	PO BOX 116156
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-6156
Country	:	US
Telephone Number	:	678-312-5525
Fax Number	:	770-339-2120

Provider Business Practice Location Address
First Line	:	1000 MEDICAL CENTER BLVD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30045-7694
Country	:	US
Telephone Number	:	678-312-3273
Fax Number	:	678-312-3282

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/10/2021

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