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Individual

ATSUKO KODAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, PHD

Contact information

Practice address
361 HIGHLAND AVE STE 204, JENKINTOWN, PA 19046-2632
(267) 538-5045
Mailing address
361 HIGHLAND AVE STE 204, JENKINTOWN, PA 19046-2632
(267) 538-5045

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD440883
PA
207N00000X
Dermatology Physician
N7443
TX
207ND0101X
MOHS-Micrographic Surgery Physician
MD440883
PA
207ND0900X
Dermatopathology Physician
MD440883
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP2-0029752
INSTITUTIONAL PERMIT
Enumeration date
05/30/2007
Last updated
05/17/2022
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