Petway, James Michael

Petway, James Michael is an individual health care provider with primary practice located at 327 Dahlonega St Suite 804, Cumming GA 30040-8209. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Petway, James Michael can be contacted via phone (770) 886-6718.

Contact Information

Primary practice address
327 Dahlonega St Suite 804 Cumming GA 30040-8209
Phone: (770) 886-6718
Fax: (770) 886-6624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X GA021271 Georgia

Profile Details

NPI number 1154319952
LBN Legal business name Petway, James Michael
Credentials M.D., F.C.C.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Feb 6th, 2012 - about 13 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 1154319952 NPPES
Georgia MEDICAID 000276438P

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