Doctor Name: | DR. MARK R. LODICO |
NPI Number: | 1700913456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD047135L |
Business Practice Address: | 7000 Stonewood Dr Suite 151 Wexford, PA - 150907376 |
Business Phone Number: | 7249330300 |
Business Fax Number: | |
Mailing Address: | 7000 Stonewood Dr, Ste. 151 WEXFORD |
State: | PA |
Postal Code: | 15090 |
Phone Number: | 7249330300 |
Fax Number: | 7249330456 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 05/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD047135L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |