Individual
DR. MARK CHRISTOPHER YAGODICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
39 RITTENHOUSE PL, ARDMORE, PA 19003-2209
(610) 642-8837
(610) 642-1607
Mailing address
39 RITTENHOUSE PL, ARDMORE, PA 19003-2209
(610) 642-8837
(610) 642-1607
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004026L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018222940001
—
PA
01
—
0981588000
INDEPENDENCE BLUE CROSS
PA
01
—
7476158
AETNA
PA
Enumeration date
08/03/2006
Last updated
03/10/2020
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