Individual
WYATT RODAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4815 LIBERTY AVE STE 439, PITTSBURGH, PA 15224-2156
(412) 359-4373
Mailing address
4815 LIBERTY AVE STE 439, PITTSBURGH, PA 15224-2156
(412) 359-4373
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD484015
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16212653
CAQH
—
Enumeration date
04/14/2016
Last updated
06/28/2024
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