MEDICARE: EDWARD M CORDASCO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	34.003896	OH
2	207RP1001X	Pulmonary Disease Physician	34.003896	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164428090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD M CORDASCO D.O.

Provider Business Mailing Address
First Line	:	PO BOX 7527
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-0727
Country	:	US
Telephone Number	:
Fax Number	:	614-544-6370

Provider Business Practice Location Address
First Line	:	3535 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3908
Country	:	US
Telephone Number	:	614-566-4691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	10/24/2024

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