Individual
DR. MARY G PETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16 WOODBINE LANE, DANVILLE, PA 17822-5206
(570) 271-8050
(570) 271-5940
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-3034
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD072732L
PA
207ND0101X
MOHS-Micrographic Surgery Physician
MD072732L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001866083
—
PA
Enumeration date
04/19/2006
Last updated
08/12/2020
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