Provider Demographics
NPI:1639169923
Name:RHODY, CHRISTOPHER EDGAR (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EDGAR
Last Name:RHODY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1312
Mailing Address - Country:US
Mailing Address - Phone:724-745-9181
Mailing Address - Fax:724-745-9240
Practice Address - Street 1:36 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1312
Practice Address - Country:US
Practice Address - Phone:724-745-9181
Practice Address - Fax:724-745-9240
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2009-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010685L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017973330007Medicaid
PAP00374732Medicare PIN
PA038892R7RMedicare PIN
PACG1496Medicare PIN
PAS85890Medicare UPIN