Individual
MR. MICHAEL BRUCE O'DONNELL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA CCC-AUDIOLOGY
Contact information
Practice address
2525 FIFTH AVE SOUTH, SUITE 2, ESCANABA, MI 49829-1204
(906) 786-5147
(906) 786-0660
Mailing address
2525 FIFTH AVE SOUTH, #2, ESCANABA, MI 49829-1204
(906) 786-5147
(906) 786-0660
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
1601000117
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54OB 102580
BC/BS OF MI
MI
01
—
64OB 126140
BC/BS OF MI
MI
Enumeration date
07/17/2006
Last updated
07/09/2007
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