Individual
DR. SAMIR ELIE KODSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1086 FRANKLIN ST, RADIOLOGY DEPT, JOHNSTOWN, PA 15905-4305
(814) 539-5987
(814) 535-4176
Mailing address
239 MAIN ST, SUITE 400, JOHNSTOWN, PA 15901-1640
(814) 539-5987
(814) 535-4176
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
229111
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD438731
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102603043
—
PA
Enumeration date
04/04/2007
Last updated
01/09/2012
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