Individual
DR. PETER E PETRUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3301 NEW MEXICO AVE NW, SUITE 206, JHCP SURGERY FOXHALL, WASHINGTON, DC 20016-3622
(202) 895-1440
(202) 895-1448
Mailing address
3100 WYMAN PARK DR, BALTIMORE, MD 21211-2803
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD5795
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
407023060
MEDICARE RAILROADERS
DC
01
—
521467441
JHCP TAX ID
—
Enumeration date
12/09/2005
Last updated
05/09/2013
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