Healthcare Provider Details

I. General information

NPI: 1891016135
Provider Name (Legal Business Name): MARY TERESA MALONEY O'DONNELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF GENERAL SURGERY 8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 13-295-2420
  • Fax:
Mailing address:
  • Phone: 202-491-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number0101251302
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: