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Organization

KENNETH E. PETRI M.D. PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH EDWARD PETRI MD (OWNER)
(303) 871-9585
Entity
Organization

Contact information

Practice address
950 E HARVARD AVE, #250, DENVER, CO 80210-7009
(303) 871-9585
(303) 871-9751
Mailing address
950 E HARVARD AVE, #250, DENVER, CO 80210-7009
(303) 871-9585
(303) 871-9751

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
15874
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04014346
CO
01
C71971
MEDICARE PROVIDER NUMBER
CO
Enumeration date
04/16/2008
Last updated
04/16/2008
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