Individual
MR. THOMAS WILLIAM PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
6701 N CHARLES ST, BALTIMORE, MD 21204-6808
(443) 849-2136
Mailing address
4118 HEDGEHILL LN, PHOENIX, MD 21131-1909
(443) 612-0434
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002025
MD
Other
Enumeration date
01/15/2007
Last updated
12/18/2012
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