Individual
EDWIN L PETRIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 SW 8TH AVE, TOPEKA, KS 66606-1535
(785) 354-5300
(785) 354-5309
Mailing address
1414 SW 8TH AVE, TOPEKA, KS 66606-1535
(785) 354-5300
(785) 354-5309
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
04-13299
KS
207RX0202X
Medical Oncology Physician
04-13299
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067031
MEDICARE PTAN
KS
05
—
100178240A
—
KS
Enumeration date
08/07/2006
Last updated
06/09/2014
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