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Individual

DR. DAVID PETTIT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
DEPT #0861, DENVER, CO 80256-0001
(866) 898-7136
(616) 975-9824
Mailing address
PO BOX 346, MESA, CO 81643-0346
(970) 268-5009

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
44370
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
27581322
CO
01
P00337534
RAILROAD
01
PENDING
CHAMPUS
CO
05
T0550
UT
Enumeration date
07/21/2006
Last updated
11/08/2007
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