MEDICARE: PETER M O'DAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	35.151194	OH
2	208M00000X	Hospitalist Physician	35.151194	OH
3	208000000X	Pediatrics Physician	35.151194	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093219487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER M O'DAY MD

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 GLESSNER AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-2269
Country	:	US
Telephone Number	:	419-526-8136
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	04/16/2026

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