Individual
DR. MARK BARNARD ODANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9700116
NC
2084P0800X
Psychiatry Physician
Primary
9700116
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135V6
BCBS NUMBER
NC
05
—
5903546
—
NC
05
—
5903560
—
NC
05
—
89135V6
—
NC
Enumeration date
09/19/2006
Last updated
06/20/2011
Update your record
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