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NPI Code Detail

MEDICARE: MALERI ROSE PETTIT CSFA

MEDICARE: MALERI ROSE PETTIT CSFA
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
1246ZC0007XSurgical AssistantGA

General Provider Information

NPI Number : 1568314953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALERI ROSE PETTIT CSFA
Provider Business Mailing Address
First Line : 3672 HIGHWAY 81
Second Line :
City : OXFORD
State : GA
Zip : 30054-3744
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2151 W SPRING ST
Second Line :
City : MONROE
State : GA
Zip : 30655-3202
Country : US
Telephone Number : 770-267-1722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ MALERI ROSE PETTIT CSFA” Practice Location

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