Healthcare Provider Details

I. General information

NPI: 1285720540
Provider Name (Legal Business Name): MICHAEL ANTHONY ODDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 W EXCHANGE ST
AKRON OH
44302-1704
US

IV. Provider business mailing address

400 WABASH AVE
AKRON OH
44307-2433
US

V. Phone/Fax

Practice location:
  • Phone: 330-762-9165
  • Fax: 330-762-0744
Mailing address:
  • Phone: 330-344-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number035029
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number035029
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: