Individual
DR. JOHANNES B ROEDL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 S 11TH ST, SUITE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6385
(215) 923-6754
Mailing address
111 S 11TH ST, SUITE 3390, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
L-236648
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD451859
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421499
—
NJ
05
—
1029327670001
—
PA
05
—
1029327670002
—
PA
Enumeration date
08/14/2008
Last updated
05/05/2015
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