Individual
RACHAEL M GEORGE ODUTAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
310 AMERICAN WAY STE A, WEIRTON, WV 26062-4083
(304) 797-6410
(304) 797-6320
Mailing address
310 AMERICAN WAY STE A, WEIRTON, WV 26062-4083
(843) 206-2031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
103156
WV
Other
Enumeration date
02/26/2019
Last updated
10/26/2022
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