Pettit, John Mark
Pettit, John Mark is an individual health care provider with primary practice located at 340 Birchwood Ave , Bellingham WA 98225-1782. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Pettit, John Mark can be contacted via phone (360) 671-9197.Contact Information
Primary practice address
340 Birchwood Ave
Bellingham WA 98225-1782
Phone: (360) 671-9197
Fax: (360) 676-7730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD00024911 | Washington |
Profile Details
| NPI number | 1407937253 |
|---|---|
| LBN Legal business name | Pettit, John Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Dec 11th, 2012 - about 12 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 | 1407937253 | NPPES |
| Washington | MEDICAID | 1032978 |
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