Individual
DR. KATHLEEN R PETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2921 TELESTAR CT, FALLS CHURCH, VA 22042-1205
(703) 280-5858
(703) 849-0874
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101248624
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
D0056845
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021602900
—
DC
05
—
906001401
—
MD
Enumeration date
07/26/2006
Last updated
08/24/2021
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