Individual
JOHN D PETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7385
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40867
WI
Other
Enumeration date
07/04/2006
Last updated
12/11/2014
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