Individual
DIMITRY MIKHAYLOVICH PETRENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1250 S CEDAR CREST BLVD STE 205, ALLENTOWN, PA 18103-6271
(610) 402-9116
(610) 402-9610
Mailing address
2608 KEISER BLVD, WYOMISSING, PA 19610-3333
(610) 685-5864
(610) 929-1528
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
OS021386
PA
207RP1001X
Pulmonary Disease Physician
Primary
OS021386
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
03/14/2023
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