Individual
DR. PETRA K WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
230 S ALABAMA AVE, CHESNEE, SC 29323-1504
(864) 461-4951
(864) 461-4956
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22043
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P010990007
RAILROAD MEDICARE
SC
05
—
T63044
—
SC
Enumeration date
05/03/2006
Last updated
06/15/2017
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