Provider Demographics
NPI:1063402246
Name:O DONNELL, CHRISTOPHER J (MD MPH)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:O DONNELL
Suffix:
Gender:M
Credentials:MD MPH
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-0995
Mailing Address - Fax:617-726-8383
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6840
Practice Address - Fax:857-203-5550
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2023-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA72184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ09570OtherBCBS MA
MA724187OtherTUFTS HEALTH PLAN
MA3061299Medicaid
MA724187OtherTUFTS HEALTH PLAN
MAJ09570Medicare ID - Type Unspecified