| Emory Mark Petrack, MD | |
|
18101 Lorain Ave, Cleveland, OH 44111-5612 | |
| (216) 476-7000 | |
| Not Available |
| Full Name | Emory Mark Petrack |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 18101 Lorain Ave, Cleveland, Ohio |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497702641 | NPI | - | NPPES |
| 942460636312 | Other | OH | CARESOURCE |
| 0887189 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 35063327 (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Emory Mark Petrack, MD 2696 W Saint James Pkwy, Cleveland Hts, OH 44106-3643 Ph: () - | Emory Mark Petrack, MD 18101 Lorain Ave, Cleveland, OH 44111-5612 Ph: (216) 476-7000 |
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