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NPI Code Detail

MEDICARE: BRIAN FRANCIS O'DONNELL MD

MEDICARE: BRIAN FRANCIS O'DONNELL 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
1207R00000XInternal Medicine Physician0101055061VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110128694OTHERVARAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1558366187
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN FRANCIS O'DONNELL MD
Provider Business Mailing Address
First Line : PO BOX 7068
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23707-0068
Country : US
Telephone Number : 757-967-8622
Fax Number : 757-686-0541
Provider Business Practice Location Address
First Line : 736 BATTLEFIELD BLVD N
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-4941
Country : US
Telephone Number : 757-967-8622
Fax Number : 757-686-0541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/21/2022

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Directions to “ BRIAN FRANCIS O'DONNELL MD” Practice Location

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