Bradley William Petkovich
Pulmonary Disease
171 Ashley Avenue
Charleston
, South Carolina 29425-0001
Bradley William Petkovich
Pulmonary Disease
171 Ashley Avenue
Charleston
, South Carolina 29425-0001
(843) 792-6200
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About
Features
Specialties
- Pulmonary Disease
Languages spoken
- English
Location
First Address
- Bradley William Petkovich
- Po Box 751461
- Charlotte, NC
- Zip : 28275-1461
- Phone : (843) 792-6200
Second Address
- Bradley William Petkovich
- 171 Ashley Avenue
- Charleston, SC
- Zip : 29425-0001
- Phone : (843) 792-1414
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RP1001X | Pulmonary Disease | 39692 | SC |
National Provider Identifier
| NPI | 1033485156 |
|---|---|
| Provider Name | Bradley William Petkovich |
| First Address | Charlotte, NC 28275-1461 |
| Second Address | Charleston, SC 29425-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/03/2012 |
| Last Update Date | 01/08/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.