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Individual

DR. MARK A. PETROFF

Active
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Individual

DR. MARK A. PETROFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
Primary
MD15996
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069609
OR
01
MD15996
STATE LICENSE
OR
Enumeration date
07/26/2005
Last updated
03/07/2023
About Stedi
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  • EDI platform