Individual
DR. MARK BARNARD ODANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
201 NORTH WINSTEAD, SUITE A, ROCKY MOUNT, NC 27804-2422
(252) 937-8222
(252) 937-6622
Mailing address
201 NORTH WINSTEAD, SUITE A, ROCKY MOUNT, NC 27804-2422
(252) 937-8222
(252) 937-6622
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
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