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Nicholas Petri, DO
General Practice Physician in Goose Creek, South Carolina
NPI 1144859729

Nicholas Petri is a General Practice Physician based in Grove City, SC. Nicholas Petri practices in Goose Creek, SC and has the professional credentials of DO. The NPI Number for Nicholas Petri is 1144859729 and holds a License No. 83718 (South Carolina).

The current practice location address for Nicholas Petri is 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC and can be reached out via phone at 843-794-6819.

Location: 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC, 43123
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144859729
Provider Name
Nicholas Petri
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
110 Naval Nuclear Power Training Command Cir, Goose Creek, SC, 43123
Phone Number
843-794-6819
Fax Number
Provider Enumeration Date
04/06/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Naval Nuclear Power Training Command Cir
City
Goose Creek
State
South Carolina
Zip
29445
Phone Number
843-794-6819
Fax Number
person
Provider Business Mailing Address Details
Address
110 Naval Nuclear Power Training Command Cir
City
Goose Creek
State
South Carolina
Zip
29445
Phone Number
843-794-6819
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
83718 (South Carolina)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
83718 (South Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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29445
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