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Individual

KEVIN F O'DONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11 NEVINS ST, SUITE 201, BRIGHTON, MA 02135-3514
(617) 789-2442
(617) 789-4207
Mailing address
11 NEVINS ST, SUITE 201, BRIGHTON, MA 02135-3514
(617) 789-2442
(617) 789-4207

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
58951
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2042711
MA
Enumeration date
10/17/2005
Last updated
10/21/2011
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