MS. THOMAS WILLIAM PETRUSICK MD - NPI 1942266788 - Pediatrics in Myrtle Beach, SC

Q: What is Thomas Petrusick's NPI number?

The NPI number for Thomas Petrusick is 1942266788. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Q: What is Thomas Petrusick's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Petrusick was last updated on July 29, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Ms. Thomas William Petrusick Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. THOMAS WILLIAM PETRUSICK MD (NPI 1942266788) is an individual pediatrics provider in Myrtle Beach, South Carolina, licensed in South Carolina (7085) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1942266788

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameMS. THOMAS WILLIAM PETRUSICKCredential: MD

Location Address8120 ROURK STMyrtle Beach, SC 29572-4127

Mailing Address8120 Rourk StMyrtle Beach, SC 29572-4127 · (843) 449-1438 · Fax (843) 286-1349

Phone(843) 449-1438

Fax(843) 286-1349

Sole ProprietorYes

Enumeration DateApril 21, 2006

Last NPPES UpdateJuly 29, 2015

✔ NPI 1942266788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in SC · 7085

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

8120 ROURK ST, Myrtle Beach, SC 29572

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Other Identifiers 1

Other570783896SC · Fed Tax Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina.Insurance ›

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KRISTIN EMILY MOORE MD

Pediatrics