Paul J Petruska
Hematology & Oncology
3660 Vista Ave
Saint Louis
, Missouri 63110-2540
Paul J Petruska
Hematology & Oncology
3660 Vista Ave
Saint Louis
, Missouri 63110-2540
(314) 977-4440
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About
Features
Specialties
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Paul J Petruska
- 3691 Rutger St Provider Enrollment
- Saint Louis, MO
- Zip : 63110-2515
- Phone : (314) 977-4440
Second Address
- Paul J Petruska
- 3660 Vista Ave
- Saint Louis, MO
- Zip : 63110-2540
- Fax : (314) 773-1167
- Phone : (314) 577-8854
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RH0003X | Hematology & Oncology | 31100 | MO |
National Provider Identifier
| NPI | 1063423622 |
|---|---|
| Provider Name | Paul J Petruska |
| First Address | Saint Louis, MO 63110-2515 |
| Second Address | Saint Louis, MO 63110-2540 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/08/2006 |
| Last Update Date | 18/03/2008 |
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.