Individual
DR. ANTHONY JOHN PETELIN
Active
Individual
DR. ANTHONY JOHN PETELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A103734
CA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
45164
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9778761
AETNA
AZ
Enumeration date
08/15/2008
Last updated
11/07/2019
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