Individual
DR. TAMARA PIROSKA PETRAC-HALATSIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5200 FAIRVIEW BOULEVARD, OB/GYN DEPARTMENT, WYOMING, MN 55092
(651) 982-7670
(651) 982-7675
Mailing address
5200 FAIRVIEW BOULEVARD, WYOMING, MN 55092
(651) 982-7670
(651) 982-7675
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
53965
MN
207V00000X
Obstetrics & Gynecology Physician
ME94155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274695600
—
FL
Enumeration date
05/22/2006
Last updated
11/09/2011
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