Mary E Petty Md Pc

LBN: Mary E Petty Md Pc
Mary E Petty Md Pc is an health care organization with primary practice located at 3 Heritage Dr Suite 1, Southgate MI 48195-3000. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Mary E Petty Md Pc can be contacted via phone (734) 283-3222, or through Petty, Mary Evelyn via phone (734) 283-3222.

Contact Information

Primary practice address
3 Heritage Dr Suite 1 Southgate MI 48195-3000
Fax: (734) 283-4006
Website:
Authorized official contact:
Name: Petty, Mary Evelyn Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MP058113 Michigan

Profile Details

NPI number 1710928544
LBN Legal business name Mary E Petty Md Pc
DBA Doing business as
Authorized official Petty, Mary Evelyn Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 10th, 2006
Last updated Jun 30th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710928544 NPPES
Other MP058113 BCBS
Other 102435 BCBS
MEDICAID 4157286 BCBS
MEDICAID 4887167 BCBS
Other 7503086 BCBS

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