Individual
DR. ADAM ADAIR PETTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2120 PROFESSIONAL DR, ROSEVILLE, CA 95661-3700
(916) 771-6662
Mailing address
1600 EUREKA RD, DEPARTMENT OF DERMATOLOGY, ROSEVILLE, CA 95661-3027
(916) 771-6662
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME90875
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48701
BLUECROSS/BLUESHIELD
FL
Enumeration date
11/23/2005
Last updated
12/13/2021
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