Provider Demographics
NPI:1710189840
Name:CORDERO, MARC
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:CORDERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HOSPITAL WAY STE 6
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2004
Mailing Address - Country:US
Mailing Address - Phone:412-672-3422
Mailing Address - Fax:412-672-8833
Practice Address - Street 1:500 HOSPITAL WAY STE 6
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2004
Practice Address - Country:US
Practice Address - Phone:412-672-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMD431727208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery