Petty, Jerry Miller
Petty, Jerry Miller is an individual health care provider with primary practice located at 225 Baldwin Ave , Charlotte NC 28204-3109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Petty, Jerry Miller can be contacted via phone (704) 376-1605.Contact Information
Primary practice address
225 Baldwin Ave
Charlotte NC 28204-3109
Phone: (704) 376-1605
Fax: (704) 335-8448
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 11925 | North Carolina |
Profile Details
NPI number | 1124027628 |
---|---|
LBN Legal business name | Petty, Jerry Miller |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 18th, 2005 |
Last updated | Dec 14th, 2020 - about 4 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 | 1124027628 | NPPES |
Other | 140004695 | RAILROAD MEDICARE | |
MEDICAID | 453681 | RAILROAD MEDICARE | |
MEDICAID | 8967385 | RAILROAD MEDICARE |
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