Individual
EDGAR C BASELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2350 FREEDOM WAY, SUITE 102, YORK, PA 17402
(717) 741-9536
(717) 741-5509
Mailing address
2350 FREEDOM WAY, SUITE 102, YORK, PA 17402
(717) 741-9536
(717) 741-5509
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD068011L
PA
208800000X
Urology Physician
Primary
MD068011L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018496900004
—
PA
01
—
02208001
CAPITAL BLUECROSS
PA
01
—
664700
HIGHMARK BLUESHIELD
PA
Enumeration date
11/01/2006
Last updated
01/12/2024
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