Organization
EDMUND STEPHEN PETRILLI, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDMUND STEPHEN PETRILLI MD (PRESIDENT)
(703) 830-8403
Entity
Organization
Contact information
Practice address
8650 SUDLEY RD, SUITE 200, MANASSAS, VA 20110-4419
(703) 392-5157
(703) 392-1347
Mailing address
8650 SUDLEY RD, SUITE 200, MANASSAS, VA 20110-4419
(703) 392-5157
(703) 392-1347
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
0101022700
VA
207VX0201X
Gynecologic Oncology Physician
Primary
0101022700
VA
Other
Enumeration date
11/16/2007
Last updated
11/19/2007
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