Provider Demographics
NPI:1588606420
Name:VRESILOVIC, EDWARD JOSEPH JR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:VRESILOVIC
Suffix:JR
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-735-1972
Mailing Address - Fax:717-735-2004
Practice Address - Street 1:1160 MANHEIM PIKE STE 200
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3127
Practice Address - Country:US
Practice Address - Phone:717-735-1972
Practice Address - Fax:717-735-2004
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-01-09
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Provider Licenses
StateLicense IDTaxonomies
PAMD038394E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA226738OtherMASS STATE LICENSE #