Individual
MR. PETER O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 828-2402
(207) 828-2425
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
21443315
ME
363L00000X
Nurse Practitioner
Primary
CNP121035
ME
Other
Enumeration date
07/03/2012
Last updated
12/18/2013
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