Individual
DR. SARA PETRUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 E CHESTNUT ST, SUITE 410, LOUISVILLE, KY 40202-5700
(502) 271-5999
(502) 271-5994
Mailing address
550 S JACKSON ST FL ST2, DEPT OB/GYN ATT VICKI MASTERSON, LOUISVILLE, KY 40202-1622
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
41568
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000564201
ANTHEM
—
01
—
000000566258
ANTHEM
—
01
—
50019063
PASSPORT PCP
KY
01
—
50019064
PASSPORT SPECIALTY
KY
01
—
50019065
PASSPORT SPECIALTY
KY
05
—
7100038810
—
KY
Enumeration date
06/28/2006
Last updated
09/29/2008
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