Individual
DRAGAN S PETAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 VARNUM AVE, STE 201, LOWELL, MA 01854
(978) 452-9700
(978) 441-6075
Mailing address
275 VARNUM AVE, STE 201, LOWELL, MA 01854
(978) 452-9700
(978) 441-6075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
157347
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158658
—
MA
05
—
0160750
—
MA
01
—
J24518
BLUE SHIELD
MA
Enumeration date
04/05/2006
Last updated
05/16/2008
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