Individual
GUY J. PETRUZZELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404
(912) 350-2299
(912) 350-2298
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-2299
(912) 350-2298
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
067957
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124903A
—
GA
05
—
003124903B
—
GA
01
—
691344
WELLCARE
GA
05
—
GA1328
—
SC
01
—
P01069298
RAILROAD MEDICARE
GA
01
—
P01109154
RAILROAD MEDICARE
GA
Enumeration date
12/30/2005
Last updated
08/07/2018
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