Provider Demographics
NPI:1063412641
Name:CODA, LOUIS E (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:E
Last Name:CODA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:112 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-262-4546
Practice Address - Fax:717-263-1146
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048473L207RH0002X, 208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1716306OtherINTERGROUP
PA4344547OtherAETNA NON-HMO
PA734976OtherHIGHMARK BLUE SHIELD
PAG920-0023/527593OtherCAREFIRST
PA25-1716306OtherMULTIPLAN/PHCS
PA3740283OtherAETNA HMO
PA50060239OtherCAPITAL BLUECROSS
PAMD048473LOtherLICENSE
PAP006158OtherGATEWAY
PA25-1716306OtherGREATWEST
PA867633OtherMEDICARE GROUP #
PA1334507OtherFIRST HEALTH
PA2131772OtherMAMSI
PA25-1716306OtherINFORMED
PAP00209078OtherRAILROAD MEDICARE
PA001408560 0004Medicaid
PA120420407OtherDEPT OF LABOR
PA193562OtherUNISON (HFC)
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA280083OtherUNISON (GI)
PA25-1716306OtherDEVON
PA441392OtherHEALTH AMERICA
PA441392OtherHEALTH AMERICA
PAP00209078OtherRAILROAD MEDICARE
PA280083OtherUNISON (GI)