Individual
DAVID EARL PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(800) 374-5326
(800) 374-7656
Mailing address
PO BOX 356, WICHITA, KS 67201-0356
(800) 374-5326
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0432621
KS
207L00000X
Anesthesiology Physician
6367
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200608960A
—
KS
01
—
P00727381
RR MEDICARE GROUP# CQ2302
KS
Enumeration date
05/01/2007
Last updated
09/22/2015
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