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Individual

DR. MICHAEL ODANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 373-4000
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 498-2020

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02005977
IN

Other

Enumeration date
03/20/2016
Last updated
12/06/2021
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