Individual
MS. SUSAN O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
930 PARK DR, STE GENEVIEVE, MO 63670-1539
(573) 883-7424
Mailing address
PO BOX 366, STE GENEVIEVE, MO 63670-0366
(573) 883-4477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
103143
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450335
UHC
MO
01
—
193294
HEALTHLINK
MO
01
—
20588
BCBS
MO
01
—
52598
GHP
MO
01
—
999553
COMMUNITY CARE PLUS
MO
01
—
E54304
MERCY HEALTH PLAN
MO
Enumeration date
02/08/2006
Last updated
10/17/2007
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