Organization
INTERNAL MEDICINE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD J. O'DONNELL MD (PRESIDENT)
(919) 774-2195
Entity
Organization
Contact information
Practice address
1139 CARTHAGE ST, SUITE 110, SANFORD, NC 27330-4111
(919) 774-2195
(919) 776-8131
Mailing address
1139 CARTHAGE ST, SUITE 110, SANFORD, NC 27330-4111
(919) 774-2195
(919) 776-8131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58264
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01786
BCBS
NC
05
—
6901786
—
NC
Enumeration date
03/22/2006
Last updated
08/22/2020
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