MPG Pediatrics, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M-001283 Issued in GU

Legal business name

MPG PEDIATRICS, P.C.

Practice address

396 Chalan San Antonio
Bri Building Suite 103
Tamvning, GU 96913

Phone

(671) 648-5437

Fax

(671) 649-5437

NPI assigned

Oct 21, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Maria Banal Blancaflor, M.D,

Title

President/Physician

Phone

(671) 648-5437

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Antonia Banal Blancaflor, M.D.

  • Specialist
  • Tamuning, GU
  • NPI 1346316825
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1487980728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 CHALAN SAN ANTONIO",
            "address_2": "BRI BUILDING SUITE 103",
            "city": "TAMVNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-648-5437",
            "fax_number": "671-649-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 CHALAN SAN ANTONIO",
            "address_2": "BRI BUILDING SUITE 103",
            "city": "TAMVNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-648-5437",
            "fax_number": "671-649-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPG PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-21",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "BLANCAFLOR",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "BANAL",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "671-648-5437",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GU",
            "license": "M-001283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.