Healthcare Provider Details

I. General information

NPI: 1730274788
Provider Name (Legal Business Name): MARGARET LEE O'DELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SOUTH PEPPER ST SUITE A
CHRISTIANSBERG VA
24073
US

IV. Provider business mailing address

210 SOUTH PEPPER ST SUITE A
CHRISTIANSBERG VA
24073
US

V. Phone/Fax

Practice location:
  • Phone: 540-381-7100
  • Fax: 540-381-7108
Mailing address:
  • Phone: 540-381-7100
  • Fax: 540-381-7108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36859
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: