Physician Compare National (NPI:1699976340)

HEALTHCARE PROVIDER: ATSUKO KODAMA MD, PHD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1699976340
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5799801114
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120919000110
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KODAMA
	Individual professional last name
Provider First Name	ATSUKO
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PATHOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PATHOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	8400 ROOSEVELT BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 200
	Group Practice or individual's line 2 address
City	PHILADELPHIA
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	191522081
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y