Mr. Michael Petrosky
Plastic and Reconstructive Surgery
120 Vann St Ne Ste 150
Marietta
, Georgia 30060-7250
Mr. Michael Petrosky
Plastic and Reconstructive Surgery
120 Vann St Ne Ste 150
Marietta
, Georgia 30060-7250
(770) 424-6652
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Mr. Michael Petrosky
- 120 Vann St Ne Ste 150
- Marietta, GA
- Zip : 30060-7250
- Fax : (770) 424-6652
- Phone : (770) 421-1242
Second Address
- Mr. Michael Petrosky
- 120 Vann St Ne Ste 150
- Marietta, GA
- Zip : 30060-7250
- Fax : (770) 424-6652
- Phone : (770) 421-1242
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | 030855 | GA |
National Provider Identifier
| NPI | 1164416582 |
|---|---|
| Provider Name | Mr. Michael Petrosky |
| First Address | Marietta, GA 30060-7250 |
| Second Address | Marietta, GA 30060-7250 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2005 |
| Last Update Date | 09/07/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 24BCBBD | PROVIDER TRANSACTION ACCESS NUMBER-PTAN (01) | GA |
| E19976 | (02) | GA |
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.