Petrosky, Michael

Petrosky, Michael is an individual health care provider with primary practice located at 120 Vann St Ne Ste 150, Marietta GA 30060-7250. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Petrosky, Michael can be contacted via phone (770) 421-1242.

Contact Information

Primary practice address
120 Vann St Ne Ste 150 Marietta GA 30060-7250
Phone: (770) 421-1242
Fax: (770) 424-6652
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 030855 Georgia

Profile Details

NPI number 1164416582
LBN Legal business name Petrosky, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Jul 9th, 2008 - about 18 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 1164416582 NPPES
Georgia Other 24BCBBD PROVIDER TRANSACTION ACCESS NUMBER-PTAN

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