Provider Demographics
NPI:1316960388
Name:PETTRONE, FRANK A (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:PETTRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75420
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-5420
Mailing Address - Country:US
Mailing Address - Phone:703-383-6469
Mailing Address - Fax:703-385-1062
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:STE 310
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3616
Practice Address - Country:US
Practice Address - Phone:703-810-5215
Practice Address - Fax:703-810-5428
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024710207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6404871Medicaid
0962280002Medicare NSC
P00186689Medicare PIN
DC1555Medicare PIN
VA6404871Medicaid
538695Medicare PIN
0962280007Medicare NSC
B93476Medicare UPIN