Individual
DR. GERARD J O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1139 CARTHAGE ST, SUITE 110, SANFORD, NC 27330-4111
(919) 774-2195
(919) 776-8131
Mailing address
1139 CARTHAGE ST, SUITE 110, SANFORD, NC 27330-4111
(919) 774-2195
(919) 776-8131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34424
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63693
BCBS
NC
05
—
8963693
—
NC
Enumeration date
03/25/2006
Last updated
04/13/2021
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