Individual
DR. MARIA T. PETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 UNIVERSITY DR, STATE COLLEGE, PA 16801-6552
(814) 234-2600
Mailing address
4520 UNION DEPOSIT RD, HARRISBURG, PA 17111-2910
(814) 599-4688
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD418272
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018922430001
—
PA
Enumeration date
12/02/2005
Last updated
03/06/2019
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