Healthcare Provider Details

I. General information

NPI: 1295182277
Provider Name (Legal Business Name): CAMILA D. ODIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 12/23/2023
Certification Date: 12/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR RM 12C103
BETHESDA MD
20892-3220
US

IV. Provider business mailing address

10 CENTER DR RM 12C103
BETHESDA MD
20892-0004
US

V. Phone/Fax

Practice location:
  • Phone: 240-338-4945
  • Fax:
Mailing address:
  • Phone: 240-338-4945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD048217
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number62994
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: