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
Fax: (575) 759-7294
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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