Petterchak, James A
Petterchak, James A is an individual health care provider with primary practice located at 3015 N. Ballas Dept Of Pathology, St. Louis MO 63131. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine. Allopathic & Osteopathic Physicians / Forensic Pathology is his primary health care specialty. Petterchak, James A can be contacted via phone (314) 996-5551.Contact Information
Primary practice address
3015 N. Ballas Dept Of Pathology
St. Louis MO 63131
Phone: (314) 996-5551
Fax: (314) 996-5551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Forensic Pathology | 207ZF0201X | 036-101883 | Illinois |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 036-101883 | Illinois |
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 036-101883 | Illinois |
Profile Details
| NPI number | 1598832032 |
|---|---|
| LBN Legal business name | Petterchak, James A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Oct 1st, 2008 - about 16 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 | 1598832032 | NPPES |
| Missouri | MEDICAID | 1598832032 |
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