Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 60050 | TN |
Y | 208000000X | Pediatrician | 83855 | SC |
N | 2080P0204X | Pediatric Emergency Doctor | 60050 | TN |
NPI | 1235662651 |
---|---|
Provider Name | Anthony Robert Oddo |
First Address | Mount Pleasant, SC 29464-6156 |
Second Address | Mount Pleasant, SC 29464-6156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 16/09/2020 |