Individual
DR. DAVID M. PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.,M.P.H.
Contact information
Practice address
4595 NEW FALLS RD STE A, LEVITTOWN, PA 19056
(267) 587-3700
(215) 752-1904
Mailing address
41 UNIVERSITY DR, SUITE 300, NEWTOWN, PA 18940-1873
(215) 710-5522
(215) 710-5181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0S004383L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011127540007
—
PA
01
—
0022484000
KEYSTONE ID
PA
01
—
036144
HIGHMARK BLUE SHIELD
PA
01
—
232173034
TAX ID
PA
01
—
491203
TRADING PARTNER BCBS
PA
01
—
P00924252
RAILROAD MEDICARE
PA
Enumeration date
10/02/2006
Last updated
07/21/2022
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