Provider Demographics
NPI:1386737807
Name:PETRO, DAVID M (DO,MPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:PETRO
Suffix:
Gender:M
Credentials:DO,MPH
Other - Prefix:
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Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-710-5522
Mailing Address - Fax:215-710-5181
Practice Address - Street 1:4595 NEW FALLS RD STE A
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056
Practice Address - Country:US
Practice Address - Phone:267-587-3700
Practice Address - Fax:215-752-1904
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA0S004383L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011127540007Medicaid
PA036144OtherHIGHMARK BLUE SHIELD
PAP00924252OtherRAILROAD MEDICARE
PA0022484000OtherKEYSTONE ID
PA491203OtherTRADING PARTNER BCBS
PA232173034OtherTAX ID
PA0022484000OtherKEYSTONE ID *
PA036144OtherHIGHMARK BLUE SHIELD