Individual
EDGAR C BASELLI
Active
Individual
EDGAR C BASELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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