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Individual

RICHARD PETRELLA SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1497 FAIR RD STE 205, STATESBORO, GA 30458-0824
(912) 259-9881
(912) 259-9883
Mailing address
1497 FAIR RD STE 205, STATESBORO, GA 30458-0824
(912) 259-9881
(912) 259-9883

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
94630
GA
207RI0011X
Interventional Cardiology Physician
MD031766-E
PA

Other

Enumeration date
06/08/2005
Last updated
08/28/2023
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