Provider Demographics
NPI:1972640092
Name:PETRE, BENJAMIN MCVAY (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:MCVAY
Last Name:PETRE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2000 MEDICAL PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3743
Mailing Address - Country:US
Mailing Address - Phone:410-295-8900
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:STE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:410-295-8900
Practice Address - Fax:410-280-4701
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2017-05-22
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Provider Licenses
StateLicense IDTaxonomies
MDP21476207X00000X
CO49711207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine