Healthcare Provider Details

I. General information

NPI: 1003839267
Provider Name (Legal Business Name): CHRISTINE E. O CONNOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 SAINT PAUL ST 6TH FLOOR
BALTIMORE MD
21202-2001
US

IV. Provider business mailing address

PO BOX 64075
BALTIMORE MD
21264-4075
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9002
  • Fax: 410-783-5880
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberD64759
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0064759
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: