Individual
DR. RONALD ANTHONY CODARIO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2511 S BROAD ST, PHILADELPHIA, PA 19148-4309
(215) 467-3883
(215) 467-2911
Mailing address
2511 S BROAD ST, PHILADELPHIA, PA 19148-4309
(215) 467-3883
(215) 467-2911
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD015340-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055123000
BLUE SHIELD PERS CHOICE
PA
01
—
0076334003
AMERICHOICE OF PA
PA
01
—
1039424
KEYSTONE MERCY
PA
Enumeration date
01/02/2007
Last updated
07/09/2007
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