EDMUND STEPHEN PETRILLI, M.D., P.C. (NPI# 1407037500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407037500 |
| Entity Type | Organization |
| Organization Name | EDMUND STEPHEN PETRILLI, M.D., P.C. |
| Practice Address |
8650 Sudley Rd Suite 200 Manassas VA 20110-4419 |
| Practice Telephone | 7033925157 |
| Practice Fax Number | 7033921347 |
| Mailing Telephone | 7033925157 |
| Mailing Fax Number | 7033921347 |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | EDMUND STEPHEN PETRILLI (PRESIDENT) |
| Authorized Official Telephone | 7038308403 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
0101022700 | VA | Allopathic & Osteopathic Physicians |
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
0101022700 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
8650 SUDLEY RD SUITE 200 |
| City | MANASSAS |
| State | VA |
| Zip Code | 20110-4419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245237718 | Jonathan Robert Amy | Psychiatry & Neurology | 8650 Sudley Rd, Suite 309, Manassas, VA 20110-4419 | 2005-06-30 |
| 1558753293 | Lori Dodd Doyle | Physician Assistant | 8650 Sudley Rd, Suite #310, Manassas, VA 20110-4419 | 2015-03-03 |
| 1386070787 | Justine Mcdermott | Audiologist | 8650 Sudley Rd, Suite 209, Manassas, VA 20110-4419 | 2013-09-18 |
| 1508130246 | Virginia Spine Specialists Pllc | Neurological Surgery | 8650 Sudley Rd, Suite 315, Manassas, VA 20110-4419 | 2012-02-27 |
| 1306976709 | George John Bitar | Plastic Surgery | 8650 Sudley Rd, Ste. 203, Manassas, VA 20110-4419 | 2007-03-06 |
| 1073676771 | Robin Elizabeth Brodie | Pediatrics | 8650 Sudley Rd, Suite 306, Manassas, VA 20110-4419 | 2006-12-18 |
| 1346303062 | Pine Grove Pediatrics | Pediatrics | 8650 Sudley Rd, Suite 306, Manassas, VA 20110-4419 | 2006-12-18 |
| 1760545479 | Susan Keller Campbell | Family Medicine | 8650 Sudley Rd, Suite 306, Manassas, VA 20110-4419 | 2006-12-18 |
| 1184707796 | Pwnc PC Corp | Specialist | 8650 Sudley Rd, Suite 300, Manassas, VA 20110-4419 | 2006-10-24 |
| 1104837244 | John P Williams | Surgery | 8650 Sudley Rd, #206, Manassas, VA 20110 | 2006-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246787 | Sini Eapen | Nurse Practitioner | 9380 Forestwood Lane, 9380 Unit B, Manassas, VA 20110 | 2020-05-18 |
| 1023662202 | United Health Home Care Agency | Registered Nurse | 8789 Commerce Ct#202, Manassas, VA 20110 | 2019-07-26 |
| 1750868097 | Elaine K. Sours, D.d.s., P.C. | Dentist | 8719 Plantation Lane, Manassas, VA 20110 | 2018-07-19 |
| 1962904573 | Donielle Francis | Specialist/Technologist | 10420 Monterosa Pl, Manassas, VA 20110 | 2018-02-28 |
| 1003332354 | Katrina Kask | Occupational Therapist | 6985 Centreville Rd., Manassas, VA 20110 | 2017-08-18 |
| 1477091478 | Mega Health Services, Inc | General Practice | 9602 Champion Ct, Manassas, VA 20110 | 2017-02-09 |
| 1811340599 | Malik Usman Dds, PC | Dentist | 8559 Sudley Road, Manassas, VA 20110 | 2016-07-19 |
| 1871944660 | Chitra Subbaraj | Physical Therapist | 8595 Centreville Rd, Manassas, VA 20110 | 2016-06-23 |
| 1093186512 | Daczkowski Orthodontics | Dentist | 8715 Stonewall Road, Manassas, VA 20110 | 2015-10-09 |
| 1851770366 | Candace Fleming | Counselor | 9242b Mosby St, Manassas, VA 20110 | 2015-05-29 |
| Find all providers in zip 20110 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700434420 | Central Virginia Gynecologic Oncology PC | Obstetrics & Gynecology | 9101 Stony Point Dr # 3300, Richmond, VA 23235-1979 | 2019-08-27 |
| 1265951818 | Bon Secours Memorial Regional Medical Center Inc | Obstetrics & Gynecology | 1510 N 28th St Ste 305, Richmond, VA 23223-5311 | 2017-09-14 |
| 1225460900 | Sherilynn Hummel | Obstetrics & Gynecology | 372 Coles Road, Burgess, VA 22432-0639 | 2013-08-05 |
| 1184811614 | Christopher Kevin Mccann | Obstetrics & Gynecology | 12720 Mcmanus Blvd Ste 308, Newport News, VA 23602-4414 | 2007-09-28 |
| 1861592339 | Randal John West | Obstetrics & Gynecology | 9101 Stony Point Dr Ste 3300, Richmond, VA 23235-1979 | 2006-09-25 |
| 1811948383 | Janet L Osborne | Obstetrics & Gynecology | 1 Riverside Cir Ste 300m, Roanoke, VA 24016-4962 | 2006-05-12 |
| 1699733808 | Chad Andrew Hamilton | Obstetrics & Gynecology | 3289 Woodburn Rd Ste 320, Annandale, VA 22003 | 2006-05-04 |
| 1730156373 | John C Elkas | Obstetrics & Gynecology | 3289 Woodburn Rd, Suite 320, Annandale, VA 22003-6800 | 2006-03-02 |
| 1902348139 | Loudoun Medical Group . P.c | Obstetrics & Gynecology | 24430 Stone Springs Blvd, Suite 100, Dulles, VA 20166-2247 | 2016-11-04 |
| 1932654886 | Bon Secours - Richmond Community Hospital, Incorporated | Obstetrics & Gynecology | 5875 Bremo Rd, Suite G-7, Richmond, VA 23226 | 2016-08-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EDMUND STEPHEN PETRILLI, M.D., P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.