Provider Demographics
NPI:1467747337
Name:RODER, NAVID A (MD)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:A
Last Name:RODER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST
Mailing Address - Street 2:9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5548
Mailing Address - Country:US
Mailing Address - Phone:215-662-8777
Mailing Address - Fax:508-860-7865
Practice Address - Street 1:3737 MARKET ST
Practice Address - Street 2:9TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5548
Practice Address - Country:US
Practice Address - Phone:215-662-8777
Practice Address - Fax:508-860-7865
Is Sole Proprietor?:No
Enumeration Date:2011-06-18
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA261063207Q00000X
PAMD462978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine