Individual
THOMAS PETROFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2445 JOLLY RD, SUITE 100, OKEMOS, MI 48864-4590
(517) 347-4040
(517) 347-4109
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101011412
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700090
PHYSICIANS HEALTH PLAN
MI
01
—
1653300644
BLUE CROSS BLUE SHIELD
MI
01
—
252501
HEALTH ADVANTAGE NETWORK
MI
05
—
4308415
—
MI
01
—
4651172
AETNA
MI
01
—
G13956
HEALTH NET FEDERAL SERVIC
MI
Enumeration date
01/10/2006
Last updated
07/08/2007
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