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NPI Code Detail

MEDICARE: JEFF ODIET MD

MEDICARE:   JEFF  ODIET  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician160253MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093705832
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFF ODIET MD
Provider Business Mailing Address
First Line : 2 ESSEX CENTER DR
Second Line :
City : PEABODY
State : MA
Zip : 01960-2902
Country : US
Telephone Number : 978-532-2800
Fax Number : 978-977-4491
Provider Business Practice Location Address
First Line : 2 ESSEX CENTER DR
Second Line :
City : PEABODY
State : MA
Zip : 01960-2902
Country : US
Telephone Number : 978-532-2800
Fax Number : 978-977-4491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 07/12/2011

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Directions to “ JEFF ODIET MD” Practice Location

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