GREGORY J PETTAWAY

SOUTH BEND, IN
NPI1851701841
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IN  01078046A)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2014-04-30
Last Update Date2022-07-21
Business Address
-- GREGORY J PETTAWAY MD
615 N MICHIGAN ST
SOUTH BEND, IN 46601-1033
Phone number: 574-647-1000
Mailing Address
-- GREGORY J PETTAWAY MD
615 N MICHIGAN ST
SOUTH BEND, IN 46601-1033
Phone number: 574-647-1817