Glenda V Pettaway, MD is a
Pediatrics physician based in Swainsboro, Georgia. Glenda V Pettaway is licensed to practice in Georgia (license number 062456) and her current practice location is 215 N Coleman St, Swainsboro, Georgia. She can be reached at her office (for appointments etc.) via phone at
(478) 237-2638.
NPI number for Glenda V Pettaway is 1841422359 and her current mailing address is 215 N Coleman St, Swainsboro, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1841422359.
Physician's Profile
| Full Name | Glenda V Pettaway |
|---|
| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 215 N Coleman St, Swainsboro, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1841422359
- Provider Enumeration Date: 08/17/2009
- Last Update Date: 02/22/2012
Medical Identifiers
Medical identifiers for Glenda V Pettaway such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841422359 | NPI | - | NPPES |
| 000632376I | Medicaid | GA | |
| 269902777A | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 062456 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Glenda V Pettaway is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Glenda V Pettaway, MD
215 N Coleman St,
Swainsboro, GA 30401-3530
Ph: (478) 237-2638 | Glenda V Pettaway, MD
215 N Coleman St,
Swainsboro, GA 30401-3530
Ph: (478) 237-2638 |
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