# DR. GREGORY BRENT DODELL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053622449
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 257597-1 | NY | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 257597-1 | NY | Yes |

## Other

- **Enumeration date:** 06/30/2010
- **Last updated:** 08/04/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04229067 | — | NY |
| 01 | — | 1053622449 | NPI | NY |