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EDMUND STEPHEN PETRILLI, M.D., P.C.

Physicians Obstetrics & Gynecology Gynecology

Provider NPI: 1407037500

Organization Information:
Organization Name:  EDMUND STEPHEN PETRILLI, M.D., P.C.
Organization is not Subpart
Authorized Official:  EDMUND STEPHEN PETRILLI  PRESIDENT  703-830-8403

Practice Location:
8650 SUDLEY RD SUITE 200 MANASSAS, VA 20110-4419 US
Tel: 703-392-5157  Fax: 703-392-1347

Business Mailing Address:
8650 SUDLEY RD SUITE 200 MANASSAS, VA 20110-4419 US
Tel: 703-392-5157  Fax: 703-392-1347

NPI Information:
NPI: 1407037500
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207VG0400XPhysicians
Obstetrics & Gynecology
Gynecology
VA0101022700
Y207VX0201XPhysicians
Obstetrics & Gynecology
VA0101022700

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207VX0201X

Type:

Classification:



Definition:



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