Individual
DR. ZANDRA RENEE PETWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5115 MARYLAND WAY, STE 65, BRENTWOOD, TN 37027
(615) 943-5503
(615) 884-0219
Mailing address
PO BOX 2018, BRENTWOOD, TN 37024-2018
(615) 933-5244
(615) 884-0219
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
27699
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3802977
—
TN
Enumeration date
07/31/2006
Last updated
12/26/2024
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