BRADLEY WILLIAM PETKOVICH


Address: 171 Ashley Avenue, Charleston, SC 29425-0001
Phone: 8437921414

BRADLEY WILLIAM PETKOVICH (NPI# 1033485156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033485156
Entity Type Individual
Full Name BRADLEY WILLIAM PETKOVICH
Credential M.D.
Practice Address 171 Ashley Avenue
Charleston
SC 29425-0001
Mailing Address Po Box 751461
Charlotte
NC 28275-1461
Practice Telephone 8437921414
Mailing Telephone 8437926200
Enumeration Date 2012-03-23
Last Update Date 2019-08-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
39692 SC Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program AR Student, Health Care

Office Location

Street Address 171 ASHLEY AVENUE
City CHARLESTON
State SC
Zip Code 29425-0001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225037765 Rachel L. Sturdivant Internal Medicine 171 Ashley Avenue, Charleston, SC 29425-0100 2005-07-18
1881238111 Lindsey Dill Willis Nurse Practitioner 171 Ashley Avenue, Charleston, SC 29425 2019-10-30
1760025258 Chad Michael Davis Nurse Practitioner 171 Ashley Avenue, Charleston, SC 29425-8908 2019-10-28
1477005700 Hannah Secunda Nurse Anesthetist, Certified Registered 171 Ashley Avenue, Charleston, SC 29412-8909 2016-11-03
1720408461 Peter O'connor Radiology 171 Ashley Avenue, Charleston, SC 29425-4756 2014-04-21
1306280474 Jennifer Battaglia Waterhouse Nurse Practitioner 171 Ashley Avenue, Charleston, SC 29425 2013-04-19
1972801470 Cheryl L Solesbee Social Worker 171 Ashley Avenue, Charleston, SC 29425-0100 2011-03-08
1700024593 Sung Wook Choi Anesthesiology 171 Ashley Avenue, Charleston, SC 29425 2009-02-02
1578759502 Evgenia Kagan Internal Medicine 171 Ashley Avenue, Charleston, SC 29425-0001 2007-09-24
1356532311 Katherine Elizabeth Twombley Pediatrics 171 Ashley Avenue, Charleston, SC 29425-8908 2007-08-06
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922607217 Krishna Bhandari Thoracic Surgery (Cardiothoracic Vascular Surgery) 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 2020-10-19
1649892456 Mary Macrae Lynch Social Worker 179 Ashley Avenue, Charleston, SC 29425 2020-05-14
1528600053 Amanda Watts Physician Assistant 135 Rutledge Ave. Msc 561, Charleston, SC 29425 2019-10-16
1851945497 Kacy Wonder Dentist 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 2019-08-01
1477114569 Justin Robert Silverman Surgery 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 2019-06-28
1740840024 Tyler Buckley Surgery 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 2019-06-18
1366001760 Rayphael Sebastian Hardy Internal Medicine 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 2019-06-10
1437718889 Samar Medani Internal Medicine Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 2019-06-10
1427617950 Emily Suzanne Nyers Internal Medicine 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 2019-06-09
1790343564 Alan Cowei Peh Psychiatry & Neurology 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 2019-06-05
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982756094 Mallinath Kayi Internal Medicine 401 Division St Ste 305, Charleston, WV 25309-1455 2007-01-17
1699786939 Sleepmed Inc. Internal Medicine 1867 Savage Rd, Charleston, SC 29407 2006-08-11
1144256819 Robert E Hillberg Internal Medicine 300 First Ave., Charleston, MA 02129-1101 2006-06-24
1063465250 Coastal Pulmonary, LLP Internal Medicine 63 Gadsden St, Charleston, SC 29401-1211 2006-05-18
1457322059 Daniel Kassaye Game Internal Medicine 1866 Raoul Wallenberg Blvd, Suite B, Charleston, SC 29407-3545 2006-01-31
1629061973 Lo'ay M. Al-asadi Internal Medicine 2335 Chesterfield Ave Ste 103, Charleston, WV 25304 2005-08-23
1053312314 Kurt M. Nellhaus, M.d. Internal Medicine 3100 Maccorkle Ave Se, Suite 806, Charleston, WV 25304-1223 2005-08-09
1255738308 Roper Saint Francis Physicians Network Internal Medicine 2095 Henry Tecklenburg Dr, Charleston, SC 29414 2014-12-04
1386930105 Mario Carlos Ponce Alvarez Internal Medicine 96 Jonathan Lucas St, Csb Suite 812, Msc 630, Charleston, SC 29425-8900 2011-06-20
1003047168 Roper Saint Francis Physicians Network Internal Medicine 2095 Henry Tecklenburg Dr, Charleston, SC 29414-5733 2009-08-06
Find all providers in CHARLESTON

Competitor

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City CHARLESTON
Zip Code 29425

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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