IndividualActive
Phillip Petterborg, OD
NPI 1376536813 · Optometrist · Dover Afb, DE
Provider details
- NPI number
- 1376536813
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- License
- ODP-730 (ID)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
300 Tuskegee Blvd
Dover Afb, DE 19902-5300
Phone: (302) 677-2574
Fax: (302) 677-2526
Street-level locationGet directions
Mailing address
906 E Pebworth Rd
Magnolia, DE 19962-1848
Registry dates
- Enumerated
- 2005-08-30
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.