Individual
DR. PATRICK J O'DEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11 TITCOMB ST, NEWBURYPORT, MA 01950-2507
(999) 000-0000
Mailing address
11 TITCOMB ST, NEWBURYPORT, MA 01950-2507
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01023960A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000084426
ANTHEM
IN
05
—
100323800
—
IN
01
—
2047381003
CIGNA
IN
01
—
4359775
AETNA
IN
01
—
791101024
RAILROAD MEDICARE
IN
Enumeration date
05/24/2005
Last updated
05/19/2016
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