Dr. Matthew Shane Petrie
Dermatologist MOHS-Micrographic Surgeon
3055 Washington Rd Suite 203
Mc Murray
, Pennsylvania 15317-3279
Dr. Matthew Shane Petrie
Dermatologist MOHS-Micrographic Surgeon
3055 Washington Rd Suite 203
Mc Murray
, Pennsylvania 15317-3279
(724) 260-5425
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Matthew Shane Petrie
- 3055 Washington Rd Suite 203
- Mc Murray, PA
- Zip : 15317-3279
- Fax : (724) 260-5425
- Phone : (724) 260-5424
Second Address
- Dr. Matthew Shane Petrie
- 3055 Washington Rd Suite 203
- Mc Murray, PA
- Zip : 15317-3279
- Fax : (724) 260-5425
- Phone : (724) 260-5424
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | D72126 | MD |
| N | 207N00000X | Dermatologist | MD438908 | PA |
| N | 207ND0101X | MOHS-Micrographic Surgeon | D72126 | MD |
| N | 207ND0101X | MOHS-Micrographic Surgeon | MD438908 | PA |
National Provider Identifier
| NPI | 1114128808 |
|---|---|
| Provider Name | Dr. Matthew Shane Petrie |
| First Address | Mc Murray, PA 15317-3279 |
| Second Address | Mc Murray, PA 15317-3279 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/05/2007 |
| Last Update Date | 09/01/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 102851711-0002 | (05) | PA |
| 60182B | (02) | NC |
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.