Individual
DR. WALTER JOSEPH O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, PULMONARY AND CRITICAL CARE COX2, BOSTON, MA 02114-2696
(617) 726-9112
(617) 643-2874
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-9112
(617) 643-2874
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
59532
MA
207RP1001X
Pulmonary Disease Physician
59532
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3080650
—
MA
01
—
730121
TUFTS HEALTH PLAN
MA
01
—
J13081
BCBS MA
MA
Enumeration date
01/13/2006
Last updated
05/05/2014
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