Roderic Ivan Pettigrew, M.D.

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

License

027106 Issued in GA

Practice address

1364 Clifton Rd NE
Department of Radiology
Atlanta, GA 30322-1059

Phone

(404) 712-5757

NPI assigned

Dec 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023177862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 W CEDAR LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141547",
            "telephone_number": "240-476-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "404-712-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "RODERIC",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "GA",
            "license": "027106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rutubula Pettaway, LCSW
• Dorothy Boling Petters, LPC
• Mary Mercedes Pettignano, A.A.
• Robert Pettignano, MD
• Michelle Ann Pettigrew, APC
• Whitney Aryn Pettigrew, LCSW
• Marianne Pettis
• Barbara Jean Pettitt, M.D.
• Katheryn P Pettus, PT
• Ashley Pettway, LPC

• Nuclear Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nuclear Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.