| Michael Logan Pettus, MD | |
|
9735 Kincey Ave Ste 100, Huntersville, NC 28078-9120 | |
| (704) 500-2332 | |
| Not Available |
| Full Name | Michael Logan Pettus |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 11 Years |
| Location | 9735 Kincey Ave Ste 100, Huntersville, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376962712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 202000739 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Caromont Regional Medical Center | Gastonia, NC | Hospital |
| Sentara Albemarle Medical Center | Elizabeth city, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Caromont Medical Group Inc | 3577476258 | 387 |
| East Carolina Anesthesia Associates Pllc | 5092720813 | 578 |
| Sarmc Anesthesia Specialist Llc | 5294032413 | 37 |
| Entity Name | Caromont Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356314272 PECOS PAC ID: 3577476258 Enrollment ID: O20031201000070 |
| Entity Name | Providence Anesthesiology Associates Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396739884 PECOS PAC ID: 3971566761 Enrollment ID: O20041111000930 |
| Entity Name | East Carolina Anesthesia Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205996519 PECOS PAC ID: 5092720813 Enrollment ID: O20060215000791 |
| Entity Name | Carolinas Pain Center Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912292335 PECOS PAC ID: 0446420525 Enrollment ID: O20110829000045 |
| Entity Name | Sarmc Anesthesia Specialist Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295194397 PECOS PAC ID: 5294032413 Enrollment ID: O20160401000764 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Logan Pettus, MD 9735 Kincey Ave Ste 100, Huntersville, NC 28078-9120 Ph: (704) 500-2332 | Michael Logan Pettus, MD 9735 Kincey Ave Ste 100, Huntersville, NC 28078-9120 Ph: (704) 500-2332 |
Dr. Joanna Monika Wroblewska-shah, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 9735 Kincey Ave, Suite 100, Huntersville, NC 28078 Phone: 704-500-2332 Fax: 888-511-8009 |