Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD011169E | PA |
NPI | 1063414597 |
---|---|
Provider Name | Dr. Charles H Srodes |
First Address | Pittsburgh, PA 15224-1770 |
Second Address | Pittsburgh, PA 15224-1770 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 07/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000647565 | (05) | PA |
B38413 | (02) | PA |