Healthcare Provider Details

I. General information

NPI: 1558393108
Provider Name (Legal Business Name): ROBIN L ODELL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN L RUMMEL

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SOUTH DR SUITE 220
MT PLEASANT MI
48858-3256
US

IV. Provider business mailing address

1201 SOUTH DR SUITE 220
MT PLEASANT MI
48858-3256
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-3411
  • Fax: 989-775-3187
Mailing address:
  • Phone: 989-773-3411
  • Fax: 989-775-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberRO015128
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: