Individual
DR. MICHEAL A ODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2376 CYPRESS CIR, STE 102, CONWAY, SC 29526-8964
(843) 347-8953
(843) 347-0226
Mailing address
300 SINGLETON RIDGE ROAD, ATTENTION PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
84064
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
840647
—
SC
Enumeration date
02/22/2006
Last updated
08/09/2024
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