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General NPI Number Information
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NPI Number | 1730151846
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Entity Type | Individual
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Provider Name | JOHN J PETRUS MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 3347 REVERE RD
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City | RICHFIELD
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State | OH
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Zip | 44286-9705
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Country | US
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Telephone | 330-461-9300
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Fax | 330-867-1195
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Provider Business Mailing Address
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Address Line | PO BOX 74589
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City | CLEVELAND
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State | OH
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Zip | 44194-4589
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Country | US
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Telephone | 330-461-9300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35-05-2725
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License Number State | OH
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