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Organization

SOPHIA B. PETKOV, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SOPHIA B PETKOV M.D. (DOCTOR)
(513) 831-3310
Entity
Organization

Contact information

Practice address
75 POWHATTON DR, MILFORD, OH 45150-1661
(513) 831-3310
(513) 831-3311
Mailing address
75 POWHATTON DR, MILFORD, OH 45150-1661
(513) 831-3310
(513) 831-3311

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000006898
ANTHEM BC-BS
OH
05
0247638
OH
01
36901
HUMANA CHOICE CARE
OH
01
645595
AETNA
OH
Enumeration date
03/20/2007
Last updated
08/22/2020
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