Individual
DR. RODERIC IVAN PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1364 CLIFTON RD NE, DEPARTMENT OF RADIOLOGY, ATLANTA, GA 30322-1059
(404) 712-5757
Mailing address
5204 W CEDAR LN, BETHESDA, MD 20814-1547
(240) 476-5899
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
027106
GA
Other
Enumeration date
12/07/2006
Last updated
07/08/2007
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