Petsonk, Edward L
Petsonk, Edward L is an individual health care provider with primary practice located at 1 Stadium Drive , Morgantown WV 26506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Petsonk, Edward L can be contacted via phone (304) 598-4800.Contact Information
Primary practice address
1 Stadium Drive
Morgantown WV 26506
Phone: (304) 598-4800
Fax: (304) 293-6963
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 12171 | West Virginia |
Profile Details
| NPI number | 1467566000 |
|---|---|
| LBN Legal business name | Petsonk, Edward L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - 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 | 1467566000 | NPPES |
| West Virginia | MEDICAID | 0083457000 |
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