Provider Demographics
NPI:1346660917
Name:O'DONNELL, ERIN PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:PATRICIA
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 W GALBRAITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-6002
Mailing Address - Country:US
Mailing Address - Phone:513-246-7000
Mailing Address - Fax:513-522-6147
Practice Address - Street 1:740 W GALBRAITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-6002
Practice Address - Country:US
Practice Address - Phone:513-246-7000
Practice Address - Fax:513-522-6147
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73448207PP0204X
MDD83332208000000X, 208M00000X
OH35.147934208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1346660917Medicaid