DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BRADLEY WILLIAM PETKOVICH M.D.

MEDICARE: BRADLEY WILLIAM PETKOVICH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease Physician2025038953MO
2207R00000XInternal Medicine Physician2025038953MO
3207RC0200XCritical Care Medicine (Internal Medicine) Physician2025038953MO

General Provider Information

NPI Number : 1033485156
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY WILLIAM PETKOVICH M.D.
Provider Business Mailing Address
First Line : 1008 S SPRING AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2520
Country : US
Telephone Number : 314-768-8622
Fax Number :
Provider Business Practice Location Address
First Line : 6420 CLAYTON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63117-1811
Country : US
Telephone Number : 314-617-3557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2012
Last Update Date : 02/05/2026

Similar Medicare Providers

1649276874 — LYNN A WHITMER MD
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8442
Practice Fax: 314-768-8918
1477541100 — JOHN G. ALEXANDER MD
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8442
Practice Fax:
1821071978 — GUIHUA CAO M.D.
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8202
Practice Fax: 314-768-7145
1851374904 — JANUSZ WOLANIUK M.D.
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8202
Practice Fax: 314-768-7145
1801879937 — GLORIA OWEN MERENDA M.D.
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8202
Practice Fax: 314-768-7145
1013990829 — ALEXANDER D BABICH M.D.
Practice Location Address:
6420 CLAYTON RD
SAINT LOUIS, MO
63117-1811
Practice Phone: 314-768-8202
Practice Fax: 314-768-7145

Directions to “ BRADLEY WILLIAM PETKOVICH M.D.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.