Individual
PETE MAYFIELD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2051 CLEVIDENCE BLVD, CLARKSVILLE, IN 47129-2278
(812) 280-9145
(812) 280-6641
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01034928A
IN
207R00000X
Internal Medicine Physician
23401
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000062915
ANTHEM - NCMA
—
01
—
000023031D
HUMANA / NCMA
KY
01
—
004329
SIHO - NCMA
—
05
—
100097290
—
IN
01
—
110138280
RRMCR - NCMA
IN
01
—
1166748
PASSPORT - NCMA
—
01
—
1193576
CHA / NCMA
KY
01
—
2440087000
PAD - NCMA
—
01
—
2533699
CIGNA / NCMA
KY
05
—
64234016
—
KY
Enumeration date
04/19/2006
Last updated
01/20/2021
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