Basic Information
| Provider Information | |||||||||
| NPI: | 1063412641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CODA | ||||||||
| FirstName: | LOUIS | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174218 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172624546 | ||||||||
| FaxNumber: | 7172631146 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 09/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0002X | MD048473L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 208000000X | MD048473L | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | MD048473L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 4344547 | 01 | PA | AETNA NON-HMO | OTHER | 734976 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | G920-0023/527593 | 01 | PA | CAREFIRST | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 3740283 | 01 | PA | AETNA HMO | OTHER | 50060239 | 01 | PA | CAPITAL BLUECROSS | OTHER | BC1388140 | 01 | PA | DEA | OTHER | MD048473L | 01 | PA | LICENSE | OTHER | P006158 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | 1334507 | 01 | PA | FIRST HEALTH | OTHER | 2131772 | 01 | PA | MAMSI | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | P00209078 | 01 | PA | RAILROAD MEDICARE | OTHER | 001408560 0004 | 05 | PA | MEDICAID | 120420407 | 01 | PA | DEPT OF LABOR | OTHER | 193562 | 01 | PA | UNISON (HFC) | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 280083 | 01 | PA | UNISON (GI) | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 441392 | 01 | PA | HEALTH AMERICA | OTHER |