Healthcare Provider Details

I. General information

NPI: 1437738168
Provider Name (Legal Business Name): MICHAEL HENRY OBRIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 14TH ST NW UNIT 125
WASHINGTON DC
20010-2415
US

IV. Provider business mailing address

800 WASHINGTON ST # 286
BOSTON MA
02111-1552
US

V. Phone/Fax

Practice location:
  • Phone: 202-921-6767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD600001714
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: