Mark J Petruzziello (NPI# 1336129535, PAC ID# 9739269101) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1336129535 |
| PAC ID by PECOS | 9739269101 |
| Professional Enrollment ID | I20091221000480 |
| Full Name | Mark J Petruzziello |
| Organization Legal Name | VIDANT MEDICAL GROUP LLC |
| Address |
101 Clinic Dr Tarboro NC 27886-1935 |
| Phone Number | 2528232105 |
| Gender | M |
| Graduation Year | 1992 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 0345343893 |
| Number of Group Practice Members | 650 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340107 | VIDANT EDGECOMBE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 101 Clinic Dr, Tarboro, NC 27886-1935 | 2528232105 | VIDANT MEDICAL GROUP LLC |
| Organization Legal Name | VIDANT MEDICAL GROUP LLC |
| Physicians | 658 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew S Peach | Radiation Oncology | Vidant Medical Group LLC | 1209 Brown St, Washington, NC 27889-4671 |
| Charnissa Nicole Batts | Nurse Practitioner | Vidant Medical Group LLC | 1308 Highland Dr, Washington, NC 27889-3424 |
| Lashaunda Brown | Clinical Social Worker | Vidant Medical Group LLC | 210 W Liberty St, Williamston, NC 27892-1712 |
| Deebah A Uddin | Internal Medicine | Vidant Medical Group LLC | 111 Hospital Dr, Tarboro, NC 27886-2011 |
| Madeline Winslow | Nurse Practitioner | Vidant Medical Group LLC | 1124 Harvey Point Rd, Hertford, NC 27944-9767 |
| Deepti Ananthula | Internal Medicine | Vidant Medical Group LLC | 1380 Cowell Farm Rd, Washington, NC 27889-3431 |
| Seetharamprasad Madala | Internal Medicine | Vidant Medical Group LLC | 500 Academy St S, Vidant Roanoke Chowan Hospitalists, Ahoskie, NC 27910-3248 |
| John P Mcgee | Family Medicine | Vidant Medical Group LLC | 2450 Emerald Pl, Vidant Family Medicine Greenville, Greenville, NC 27834-5784 |
| Judith Tate Smithwick | Nurse Practitioner | Vidant Medical Group LLC | 1210 N Brown St, Vidant Womens Care Washington, Washington, NC 27889-4671 |
| David A Konzem | Physician Assistant | Vidant Medical Group LLC | 417 N Main St B, Kenansville, NC 28349-8801 |
| Street Address |
101 CLINIC DR |
| City | TARBORO |
| State | NC |
| Zip | 27886-1935 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angela B Mebane | Family Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Meridith M Taylor | Family Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Bradford Bilicki | General Surgery | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Kimberly Obrien | Physician Assistant | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Donneshia G Moore | Internal Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Manisha Tiwari | Internal Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Ramesh R Mishra | Internal Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| David C Miller | Orthopedic Surgery | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Ada F Williams-wooten | Pediatric Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Paul R Woodard Ii | Internal Medicine | Vidant Medical Group LLC | 101 Clinic Dr, Tarboro, NC 27886-1935 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Savannah D Junkins | Physician Assistant | Carolina Family Health Centers Inc | 162 Nc 33 E Hwy, Tarboro, NC 27886 |
| James W Winslow | Family Medicine | 122 E Saint St, Tarboro, NC 27886 | |
| Clifton J Williams | Physician Assistant | Carolina Family Health Centers Inc | 162 Nc 33 E Hwy, Tarboro, NC 27886 |
| Thanh Truc Brooks | Nurse Practitioner | Carolina Family Health Centers Inc | 162 Nc 33 E Hwy, Tarboro, NC 27886 |
| Sarah Tyson | Optometry | Tarboro Eye Associates Optometry Pllc | 2807 N Main St, Tarboro, NC 27886-1903 |
| Alvah Carl Cayton Iv | Optometry | Tarboro Eye Associates Optometry Pllc | 2807 N Main St, Tarboro, NC 27886-1903 |
| Emma Castillo | Internal Medicine | 2704 N Main St, C, Tarboro, NC 27886-1918 | |
| James Eugene Kendall Jr. | Obstetrics/gynecology | Vidant Medical Group LLC | 2704 N Main St, Tarboro, NC 27886-1918 |
| Jil H Brown | Nurse Practitioner | Vidant Medical Group LLC | 2704 N Main St, Tarboro, NC 27886-1918 |
| Steven C Spruill | Obstetrics/gynecology | Vidant Medical Group LLC | 2704 N Main St, Tarboro, NC 27886-1918 |
| Find all physicians in zip 27886 | |||
| City | TARBORO |
| Zip Code | 27886 |
| Specialty | GENERAL SURGERY |
| City + Specialty | TARBORO + GENERAL SURGERY |
Please comment or provide details below to improve the information on Mark J Petruzziello.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.