Mark A. Petroff in Lake Oswego - Plastic Surgery Within The Head And Neck
Mark A. Petroff - NPI 1528068129
Mark A. Petroff is a Plastic Surgery Within The Head And Neck in Lake Oswego, Oregon. Mark A. Petroff practices all healthcare services and medical treatments related to Plastic Surgery Within The Head And Neck. The NPI Number for Mark A. Petroff is 1528068129. The last update date is 2023-03-07.
Mark A. Petroff's current location address is 17720 Jean Way, Lake Oswego, Oregon. You can contact this provider via phone number 5036354886 and fax number 5036351655. The mailing address for Mark A. Petroff is 17720 Jean Way, Lake Oswego, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark A. Petroff |
|---|---|
| Address | 17720 Jean Way, Lake Oswego, Oregon |
| Phone Number | 5036354886 |
| Fax Number | 5036351655 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1528068129 |
|---|---|
| Provider Enumeration Date | 2005-07-26 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 17720 Jean Way |
|---|---|
| City | Lake Oswego |
| State | Oregon (OR) |
| Post Code | 970355394 |
| Phone Number | 5036354886 |
| Fax Number | 5036351655 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic Surgery Within The Head And Neck |
|---|---|
| Taxonomy | 2082S0099X |
| Licence No | MD15996 |
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Definition: A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| MD15996 | OR | STATE LICENSE | |
| 69609 | OR | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Mark A. Petroff by the Centers for Medicare & Medicaid Services?
The Mark A. Petroff has been assigned the NPI (National Provider Identifier) 1528068129. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Mark A. Petroff?
The Mark A. Petroff is situated at 17720 Jean Way, in the city of Lake Oswego, state of OR, with the zip code 970355394.
What is the Mark A. Petroff's area of specialization and corresponding taxonomy classification?
The Mark A. Petroff's specialty field is Plastic Surgery Within The Head And Neck, and it falls under the taxonomy code 2082S0099X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1528068129 to Mark A. Petroff?
The Centers for Medicare & Medicaid Services assigned the 1528068129 to Mark A. Petroff on 2005-07-26.
As of what date was the information regarding Mark A. Petroff, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark A. Petroff, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2023-03-07.
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