Petok, Tina

Petok, Tina is an sole proprietor health care provider with primary practice located at 8220 University Exec Park Dr Suite 107, Charlotte NC 28262-3380. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Petok, Tina can be contacted via phone (704) 548-1221.

Contact Information

Primary practice address
8220 University Exec Park Dr Suite 107 Charlotte NC 28262-3380
Phone: (704) 548-1221
Fax: (704) 548-1311
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 32417 North Carolina

Profile Details

NPI number 1861464810
LBN Legal business name Petok, Tina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2006
Last updated Oct 2nd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861464810 NPPES
North Carolina MEDICAID 8967234

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