Petrusick, Thomas William

Petrusick, Thomas William is an sole proprietor health care provider with primary practice located at 8120 Rourk St , Myrtle Beach SC 29572-4127. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Petrusick, Thomas William can be contacted via phone (843) 449-1438.

Contact Information

Primary practice address
8120 Rourk St Myrtle Beach SC 29572-4127
Phone: (843) 449-1438
Fax: (843) 286-1349
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 7085 South Carolina

Profile Details

NPI number 1942266788
LBN Legal business name Petrusick, Thomas William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 21st, 2006
Last updated Jul 29th, 2015 - about 10 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 1942266788 NPPES
South Carolina Other 570783896 FED TAX ID

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