Provider Demographics
NPI:1679892251
Name:O'DEA, ROBERT FRANCIS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANCIS
Last Name:O'DEA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:576 EBEN CT
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-3725
Mailing Address - Country:US
Mailing Address - Phone:651-353-4147
Mailing Address - Fax:651-439-1930
Practice Address - Street 1:576 EBEN CT
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-3725
Practice Address - Country:US
Practice Address - Phone:651-353-4147
Practice Address - Fax:651-439-1930
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-22
Last Update Date:2010-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN22222208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology