Healthcare Provider Details

I. General information

NPI: 1679983340
Provider Name (Legal Business Name): XODO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 E EDGEWOOD DR
MC MURRAY PA
15317-3355
US

IV. Provider business mailing address

239 E EDGEWOOD DR
MC MURRAY PA
15317-3355
US

V. Phone/Fax

Practice location:
  • Phone: 724-825-5943
  • Fax:
Mailing address:
  • Phone: 724-825-5943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID A CELKO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 724-825-5943