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DR. ERICKA M. RUSSELL PETTY M.D. NPI 1659362705


NPI Information

NPI: 1659362705
Provider Name: DR. ERICKA M. RUSSELL PETTY, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
3710 WATERS AVE
SAVANNAH, GA
ZIP 31404
Phone: (912) 777-5490
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DR. Ericka M. Russell Petty, M.D. is a pediatrics in Savannah, GA. The provider is 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. DR. Ericka M. Russell Petty, M.D. NPI is 1659362705. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3710 WATERS AVE
SAVANNAH, GA
ZIP 31404-209
Phone: (912) 777-5490
Fax: (912) 777-5491

The enumeration date for this NPI number is 10/28/2005 and was last updated on 8/13/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics047258GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000880448EMEDICAIDGEORGIA
2000880448CMEDICAIDGEORGIA
3000880448HMEDICAIDGEORGIA
4000880448DMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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