Petrosky, Michael
Petrosky, Michael is an individual health care provider with primary practice located at 120 Vann St Ne Ste 150, Marietta GA 30060-7250. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Petrosky, Michael can be contacted via phone (770) 421-1242.Contact Information
Primary practice address
120 Vann St Ne Ste 150
Marietta GA 30060-7250
Phone: (770) 421-1242
Fax: (770) 424-6652
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 030855 | Georgia |
Profile Details
| NPI number | 1164416582 |
|---|---|
| LBN Legal business name | Petrosky, Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Jul 9th, 2008 - about 17 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 | 1164416582 | NPPES |
| Georgia | Other | 24BCBBD | PROVIDER TRANSACTION ACCESS NUMBER-PTAN |
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