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
Phone: (314) 797-7074
Fax: (314) 227-5505
Website:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023089562 | NPPES |
| Missouri | MEDICAID | 207235706 |
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