Odegaard, Mary E
Odegaard, Mary E is an individual health care provider with primary practice located at 111 Grossman Dr Family Medicine, Braintree MA 02184-4997. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Odegaard, Mary E can be contacted via phone (781) 849-2560.Contact Information
Primary practice address
111 Grossman Dr Family Medicine
Braintree MA 02184-4997
Phone: (781) 849-2560
Fax: (781) 849-2529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 81548 | Massachusetts |
Profile Details
| NPI number | 1942291349 |
|---|---|
| LBN Legal business name | Odegaard, Mary E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | Oct 23rd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942291349 | NPPES |
| Other | 080078724 | RR MEDICARE | |
| Other | 081548 | RR MEDICARE | |
| Other | ODJ16519 | RR MEDICARE | |
| Other | 70989 | RR MEDICARE | |
| Other | 3552899 | RR MEDICARE | |
| MEDICAID | 3155102 | RR MEDICARE |
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