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Individual
ARTHUR S PETTIGREW
Active
Individual
ARTHUR S PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036101644
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101644
—
IL
01
—
080158547
RAILROAD MEDICARE PTAN
IL
01
—
399980
MEDICARE GROUP PTAN
IL
Enumeration date
01/09/2007
Last updated
03/25/2021
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