Provider Demographics
NPI:1013030642
Name:O'DONNELL, MARY BECK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:BECK
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2960 SLEEPY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2030
Mailing Address - Country:US
Mailing Address - Phone:703-536-2000
Mailing Address - Fax:703-536-4256
Practice Address - Street 1:2960 SLEEPY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2030
Practice Address - Country:US
Practice Address - Phone:703-536-2000
Practice Address - Fax:703-536-4256
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101046671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine