Individual
JOHN PETRASKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
608 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 899-4797
Mailing address
608 JACKSON ST, FREDERICKSBURG, VA 22401-5719
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0101245896
VA
251K00000X
Public Health or Welfare Agency
JP049321
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02149321
BCBS PIN
MI
05
—
23 5100232
—
MI
05
—
23 5100241
—
MI
05
—
77 2668591
—
MI
05
—
77 2681038
—
MI
Enumeration date
02/06/2007
Last updated
07/10/2009
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