Healthcare Provider Details

I. General information

NPI: 1437185972
Provider Name (Legal Business Name): CAROLYN BAIER O'CONOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32060 LONG NECK RD STE 501
MILLSBORO DE
19966-6228
US

IV. Provider business mailing address

32060 LONG NECK RD
MILLSBORO DE
19966-6228
US

V. Phone/Fax

Practice location:
  • Phone: 302-947-1202
  • Fax:
Mailing address:
  • Phone: 302-947-1202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD34386
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD34386
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC1-0026289
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: