Individual
DR. VLADIMIR PETORAK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 MEDICAL PARK DR, LEWISBURG, PA 17837-6343
(570) 524-2722
(570) 524-0362
Mailing address
1 HOSPITAL DR STE 306, LEWISBURG, PA 17837-9350
(570) 522-4110
(570) 768-3911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD043726L
PA
207RG0100X
Gastroenterology Physician
Primary
MD043726L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014277710004
—
PA
Enumeration date
11/14/2005
Last updated
06/09/2022
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