Michael Petruschak, MD | |
736 Battlefield Blvd N, Chesapeake, VA 23320-4941 | |
(757) 312-8121 | |
Not Available |
Full Name | Michael Petruschak |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 736 Battlefield Blvd N, Chesapeake, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053328658 | NPI | - | NPPES |
01011237966 | Other | VA | MEDICAL LICENSE |
010159156 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 0101237966 (Virginia) | Primary |
Entity Name | Chesapeake Radiologists Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801815063 PECOS PAC ID: 4183619950 Enrollment ID: O20040420000329 |
Mailing Address | Practice Location Address |
---|---|
Michael Petruschak, MD Po Box 1707, Chesapeake, VA 23327-1707 Ph: (757) 366-0101 | Michael Petruschak, MD 736 Battlefield Blvd N, Chesapeake, VA 23320-4941 Ph: (757) 312-8121 |
Dr. Salvador Bernard Trinidad, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 736 Battlefield Blvd N, Radiology Department, Chesapeake, VA 23320 Phone: 757-366-0101 Fax: 757-366-8792 | |
Sanjay Patel, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 736 Battlefield Blvd N, Chesapeake, VA 23320 Phone: 757-312-6124 | |
Juliana Ballestero, Radiology Medicare: Accepting Medicare Assignments Practice Location: 736 Battlefield Blvd N, Chesapeake, VA 23320 Phone: 757-312-8121 | |
Domingo C Tan, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 736 Battlefield Blvd N, Chesapeake, VA 23320 Phone: 757-312-6124 Fax: 757-312-6195 | |
John Daughdrille, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 736 Battlefield Blvd N, Chesapeake, VA 23320 Phone: 757-312-8121 | |
Dr. Mathew Sinesi, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 736 Battlefield Blvd N, Chesapeake, VA 23320 Phone: 757-312-6294 |