Christopher Conrad Petruccelli, | |
22 S Greene St Rm N3e09, Baltimore, MD 21201-1544 | |
(410) 328-6110 | |
Not Available |
Full Name | Christopher Conrad Petruccelli |
---|---|
Gender | Male |
Speciality | Hospitalist |
Experience | 5 Years |
Location | 22 S Greene St Rm N3e09, Baltimore, Maryland |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629539457 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D93989 (Maryland) | Secondary |
208M00000X | Hospitalist | D93898 (Maryland) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
University Of Md Baltimore Washington Medical Center | Glen burnie, MD | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mdics At Bwmc Llc | 7315106184 | 59 |
Entity Name | Mdics At Bwmc Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306131578 PECOS PAC ID: 7315106184 Enrollment ID: O20120314000455 |
Mailing Address | Practice Location Address |
---|---|
Christopher Conrad Petruccelli, 22 S Greene St Rm N3e09, Baltimore, MD 21201-1544 Ph: () - | Christopher Conrad Petruccelli, 22 S Greene St Rm N3e09, Baltimore, MD 21201-1544 Ph: (410) 328-6110 |
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