IndividualActive
Michael Petrosky, MD
NPI 1164416582 · Plastic and Reconstructive Surgery Physician · Marietta, GA
Provider details
- NPI number
- 1164416582
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 030855 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
120 Vann St Ne
Ste 150
Marietta, GA 30060-7250
Phone: (770) 421-1242
Fax: (770) 424-6652
Approximate (ZIP-level) locationGet directions
Mailing address
120 Vann St Ne
Marietta, GA 30060-7250
Registry dates
- Enumerated
- 2005-08-31
- Last updated
- 2008-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.