Petrasky, John

Petrasky, John is an sole proprietor health care provider with primary practice located at 608 Jackson St , Fredericksburg VA 22401-5719. He recently has 2 registered licenses in different health care specialties including Agencies / Public Health or Welfare, Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine. Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine is his primary health care specialty. Petrasky, John can be contacted via phone (540) 899-4797.

Contact Information

Primary practice address
608 Jackson St Fredericksburg VA 22401-5719
Phone: (540) 899-4797
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X JP049321 Michigan
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 0101245896 Virginia

Profile Details

NPI number 1225177975
LBN Legal business name Petrasky, John
Credentials M.D., M.P.H.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2007
Last updated Jul 10th, 2009 - about 16 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 1225177975 NPPES
Michigan MEDICAID 23 5100241
Michigan Other 02149321
Michigan MEDICAID 23 5100232
Michigan MEDICAID 77 2681038
Michigan MEDICAID 77 2668591

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