Individual ProviderStephen O'DonnellAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address111 Colchester Ave, Fahc Wp 2, Burlington, VT 05401-1473(802) 847-2415PECOS EnrollmentBased on the most recent information from CMS, provider Stephen O'Donnell is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1194769760Provider TypeIndividualFull NameO'Donnell, StephenCredentialM.D.GenderMaleEnumeration Date6/15/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address111 Colchester Ave, Fahc Wp 2, Burlington, VT 05401-1473Phone(802) 847-2415Fax(802) 847-5324Mailing LocationMailing Address111 Colchester Ave, Fahc Wp 2, Burlington, VT 05401-1473Phone(802) 847-2415Fax(802) 847-5324Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense042-0009330VermontProvider IdentifiersIDDescriptionIssuerIDOVN1378DescriptionMedicaidIssuerUnlistedVermontID01665136DescriptionMedicaidIssuerUnlistedNew York