Individual
DR. MATTHEW ALEXANDER PETRILLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
504 WILBORN AVE FL 5, SOUTH BOSTON, VA 24592-3120
(434) 517-3400
Mailing address
504 WILBORN AVE FL 5, SOUTH BOSTON, VA 24592-3120
(434) 517-3400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101267115
VA
2084P0800X
Psychiatry Physician
Primary
2020-00301
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87-204216
PSYCHIATRY
NC
Enumeration date
12/14/2014
Last updated
09/27/2024
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