Healthcare Provider Details

I. General information

NPI: 1265791818
Provider Name (Legal Business Name): GAETAN LORENZ PETTIGREW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

301 5TH AVE APT 615
PITTSBURGH PA
15222-2433
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-8551
  • Fax:
Mailing address:
  • Phone: 412-282-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA143683
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA143683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: