Petrick, Maria M.

Petrick, Maria M. is an individual health care provider with primary practice located at 130 Stony Point Rd Suite E, Santa Rosa CA 95401-4120. She recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as her primary health care specialty. Petrick, Maria M. can be contacted via phone (707) 525-0211.

Contact Information

Primary practice address
130 Stony Point Rd Suite E Santa Rosa CA 95401-4120
Phone: (707) 525-0211
Fax: (707) 525-0491
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 40808 Kentucky
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 01063403A Indiana
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X C132754 California

Profile Details

NPI number 1396743605
LBN Legal business name Petrick, Maria M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Nov 16th, 2015 - about 9 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 1396743605 NPPES
Kentucky Other 000000514027 ANTHEM PIN
Kentucky Other HKRAA3F00 ANTHEM PIN
Kentucky Other P00411953 ANTHEM PIN
Kentucky Other ZZZ95243Z ANTHEM PIN
Kentucky MEDICAID 200855600 ANTHEM PIN
Kentucky MEDICAID 7100013590 ANTHEM PIN
Kentucky Other 50015240 ANTHEM PIN
Kentucky MEDICAID GR0061440 ANTHEM PIN

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