Individual
BRADLEY WILLIAM PETKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8622
(314) 768-7177
Mailing address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 768-8622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2025038953
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2025038953
MO
207RP1001X
Pulmonary Disease Physician
Primary
2025038953
MO
Other
Enumeration date
03/23/2012
Last updated
03/17/2026
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