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NPI Code Detail

MEDICARE: CODEY A TYDA MD

MEDICARE: CODEY A TYDA MD
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
12084N0400XNeurology Physician35147925OH

General Provider Information

NPI Number : 1467015271
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODEY A TYDA MD
Provider Business Mailing Address
First Line : 2222 CHERRY ST STE M200
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2674
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2222 CHERRY ST STE M200
Second Line :
City : TOLEDO
State : OH
Zip : 43608-2674
Country : US
Telephone Number : 419-251-8019
Fax Number : 419-251-5819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2019
Last Update Date : 12/17/2025

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Directions to “ CODEY A TYDA MD” Practice Location

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