Provider Demographics
NPI:1902840713
Name:ODONNELL, JOHN B (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:ODONNELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 N CALVERT ST
Mailing Address - Street 2:STE 400
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218
Mailing Address - Country:US
Mailing Address - Phone:410-554-2270
Mailing Address - Fax:410-261-2726
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:STE 400
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218
Practice Address - Country:US
Practice Address - Phone:410-554-2270
Practice Address - Fax:410-261-2726
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD35423207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ848OtherCFBCBS DC
MD1902840713OtherNPI NUMBER
MD903AOtherCFBCBS MD
MD520591685OtherTIN
MD903AOtherCFBCBS MD
MDC75467Medicare UPIN