Individual
MRS. DENISE MARIE PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 MARCLEY DRIVE, MARTINSBURG, WV 25401
(304) 263-8911
(304) 263-9450
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 536-5100
(304) 263-9450
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01252
WV
363AM0700X
Medical Physician Assistant
MA052197
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9930421
MEDICARE GROUP NUMBER
WV
Enumeration date
07/13/2006
Last updated
09/23/2021
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