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General NPI Number Information
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NPI Number | 1184804130
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Entity Type | Organization
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Legal Business Name | DAVID M. PETRO D.O.,M.P.H.
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 200 JUNEWOOD DR
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City | LEVITTOWN
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State | PA
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Zip | 19055-2324
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Country | US
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Telephone | 215-943-0424
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Fax | 215-943-8665
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Provider Business Mailing Address
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Address Line | PO BOX 669
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City | LEVITTOWN
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State | PA
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Zip | 19058-0669
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Country | US
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Telephone | 215-943-0424
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Fax | 215-943-8665
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAVID M PETRO
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Credential | D.O.,M.P.H.
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Telephone | 215-943-0424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS004383L
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License Number State | PA
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