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General NPI Number Information
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NPI Number | 1558468389
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Entity Type | Organization
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Legal Business Name | DIEGO R. CORDOBA, M.D. LTD
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 MEDICAL ARTS BLDG SUITE 140
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City | KITTANNING
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State | PA
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Zip | 16201-7135
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Country | US
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Telephone | 724-548-4701
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Fax | 724-548-2003
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Provider Business Mailing Address
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Address Line | 100 MEDICAL ARTS BLDG SUITE 140
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City | KITTANNING
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State | PA
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Zip | 16201-7135
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Country | US
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Telephone | 724-548-4701
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Fax | 724-548-2003
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIEGO R CORDOBA
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Credential | M.D.
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Telephone | 724-548-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD035116L
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License Number State | PA
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