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Organization

PAUL PETRE MD PC

Active
Parent organization
PAUL PETRE MD PC
Other names
Great Lakes Portable Diagnostics
Organization subpart
Yes

Provider details

NPI number
Legal business name
PAUL PETRE MD PC
Authorized official
PAUL PETRE MD (PRESIDENT)
(586) 573-6400
Entity
Organization

Contact information

Practice address
28800 RYAN RD, SUITE 300, WARREN, MI 48092-4272
(586) 573-6400
(586) 573-1918
Mailing address
30781 STEPHENSON HWY, MADISON HTS, MI 48071-1618
(248) 284-2316
(248) 583-8969

Taxonomy

Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary

Other

Enumeration date
11/21/2008
Last updated
11/21/2008
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