Petrick, Mary G
Petrick, Mary G is an individual health care provider with primary practice located at 16 Woodbine Lane , Danville PA 17822-5206. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Petrick, Mary G can be contacted via phone (570) 271-8050.Contact Information
Primary practice address
16 Woodbine Lane
Danville PA 17822-5206
Phone: (570) 271-8050
Fax: (570) 271-5940
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | MD072732L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD072732L | Pennsylvania |
Profile Details
| NPI number | 1639134919 |
|---|---|
| LBN Legal business name | Petrick, Mary G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Aug 12th, 2020 - about 4 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 | 1639134919 | NPPES |
| Pennsylvania | MEDICAID | 001866083 |
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