Doctor Name: | BARRRY N ODEGAARD |
NPI Number: | 1700975000 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 3674 |
Business Practice Address: | 4211 Waialae Ave Ste 407 Honolulu, HI - 968165317 |
Business Phone Number: | 8087322004 |
Business Fax Number: | 8087324420 |
Mailing Address: | 4211 Waialae Ave Ste 407, HONOLULU |
State: | HI |
Postal Code: | 968165317 |
Phone Number: | 8087322004 |
Fax Number: | 8087324420 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 3674 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |