Amy Viola Petrie, PAC is a
Physician Assistant - Medical based in Niles, Michigan. Amy Viola Petrie is licensed to practice in Michigan (license number 5601006305) and her current practice location is
2002 S 11th St, Niles, Michigan. She can be reached at her office (for appointments etc.) via phone at
(269) 687-0200.
NPI number for Amy Viola Petrie is 1649386319 and her current mailing address is 6416 Deans Hill Rd, Berrien Center, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649386319.
Provider's Profile
| Full Name | Amy Viola Petrie |
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| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 2002 S 11th St, Niles, Michigan |
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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: 1649386319
- Provider Enumeration Date: 08/22/2006
- Last Update Date: 03/14/2013
Medical Identifiers
Medical identifiers for Amy Viola Petrie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649386319 | NPI | - | NPPES |
| 1649386319 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | 085002713 (Illinois) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 5601006305 (Michigan) | 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. Amy Viola Petrie 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 |
|---|
Amy Viola Petrie, PAC
6416 Deans Hill Rd,
Berrien Center, MI 49102-9750
Ph: (269) 471-7741 | Amy Viola Petrie, PAC
2002 S 11th St,
Niles, MI 49120-4074
Ph: (269) 687-0200 |
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