Petrosova, Tatyana

Petrosova, Tatyana is an sole proprietor health care provider with primary practice located at 10420 Old Olive Street Rd Ste 305 , Saint Louis MO 63141-5914. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Petrosova, Tatyana can be contacted via phone (314) 797-7074.

Contact Information

Primary practice address
10420 Old Olive Street Rd Ste 305 Saint Louis MO 63141-5914
Fax: (314) 227-5505
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 2002007108 Missouri
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036107203 Illinois

Profile Details

NPI number 1023089562
LBN Legal business name Petrosova, Tatyana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated Jun 9th, 2024 - about 6 months 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 1023089562 NPPES
Missouri MEDICAID 207235706

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