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Individual
PETRA MAMIC
Active
Individual
PETRA MAMIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A131889
CA
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
036180939
IL
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
A131889
CA
207RC0000X
Cardiovascular Disease Physician
036180939
IL
207RC0000X
Cardiovascular Disease Physician
A131889
CA
Other
Enumeration date
03/25/2013
Last updated
09/24/2026
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