Individual
EDWARD ROBERT VILLELLA II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
(724) 773-8289
(724) 773-4532
Mailing address
1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
(724) 773-8289
(724) 773-4532
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD443921
PA
208600000X
Surgery Physician
MT-194653
PA
2086S0129X
Vascular Surgery Physician
Primary
MD443921
PA
Other
Enumeration date
01/28/2011
Last updated
04/22/2019
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