Individual
DR. ANTHONY JOHN PETELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14275 N 87TH ST, SUITE #110, SCOTTSDALE, AZ 85260-3696
(480) 905-8485
(480) 905-7274
Mailing address
14275 N 87TH ST, SUITE #110, SCOTTSDALE, AZ 85260-3696
(480) 905-8485
(480) 905-7274
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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