Organization
FCG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CODELLA M.D. (MEDICAL DIRECTOR)
(215) 728-6688
Entity
Organization
Contact information
Practice address
1403 RHAWN STREET, PHILADELPHIA, PA 19111-2430
(215) 728-6688
(215) 342-1337
Mailing address
1403 RHAWN STREET, PHILADELPHIA, PA 19111-2430
(215) 728-6688
(215) 342-1337
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
07/26/2006
Last updated
02/06/2008
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