Pettitt, Raena M.

Pettitt, Raena M. is an individual health care provider with primary practice located at 2321 Wards Rd , Lynchburg VA 24502-2101. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pettitt, Raena M. can be contacted via phone (434) 582-2273.

Contact Information

Primary practice address
2321 Wards Rd Lynchburg VA 24502-2101
Phone: (434) 582-2273
Fax: (434) 582-1363
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0102201453 Virginia

Profile Details

NPI number 1124025085
LBN Legal business name Pettitt, Raena M.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2005
Last updated Sep 21st, 2016 - about 10 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 1124025085 NPPES
Virginia MEDICAID 010215048
Virginia Other 203639329013
Virginia Other 010215048
Virginia Other 186414
Virginia Other 203639329
Virginia Other D5084
Virginia Other 2379390
Virginia Other 78660
Virginia Other 203639329
Virginia Other 329088

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