Provider Demographics
NPI:1730274788
Name:O'DELL, MARGARET LEE (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:LEE
Last Name:O'DELL
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 1:210 SOUTH PEPPER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHRISTIANSBERG
Mailing Address - State:VA
Mailing Address - Zip Code:24073
Mailing Address - Country:US
Mailing Address - Phone:540-381-7100
Mailing Address - Fax:540-381-7108
Practice Address - Street 1:210 SOUTH PEPPER ST
Practice Address - Street 2:SUITE A
Practice Address - City:CHRISTIANSBERG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-381-7100
Practice Address - Fax:540-381-7108
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0188946Medicaid
IAC47365Medicare UPIN
IA49614Medicare ID - Type UnspecifiedMEDICARE PART B
IA0188946Medicaid