Petrakis, Steven John
Petrakis, Steven John is an individual health care provider with primary practice located at 500 North Mundo , Dulce NM 87528-2725. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Petrakis, Steven John can be contacted via phone (575) 759-3291.Contact Information
Primary practice address
500 North Mundo
Dulce NM 87528-2725
Phone: (575) 759-3291
Fax: (575) 759-7294
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | NM96-117 | New Mexico |
Profile Details
| NPI number | 1265591606 |
|---|---|
| LBN Legal business name | Petrakis, Steven John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2006 |
| Last updated | Aug 11th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265591606 | NPPES |
| New Mexico | Other | 8HN067 | MEDICARE PTAN # |
| New Mexico | MEDICAID | K3526 | MEDICARE PTAN # |
| New Mexico | Other | 000S5584 | MEDICARE PTAN # |
| New Mexico | Other | HSZ196 | MEDICARE PTAN # |
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