Individual
PETER GEORGE MAVRELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7895 GRAND BLVD, HOBART, IN 46342-6665
(219) 947-1910
(219) 758-5009
Mailing address
7895 GRAND BLVD, HOBART, IN 46342-6665
(219) 947-1910
(219) 758-5009
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01030831A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085027
ANTHEM BC/BS
IN
05
—
100138640A
—
IN
01
—
110044491
RAILROAD MEDICARE
IN
01
—
9115389
ANTHEM BC/BS
IL
Enumeration date
06/15/2005
Last updated
12/09/2022
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