Healthcare Provider Details
I. General information
NPI: 1629049416
Provider Name (Legal Business Name): MICHAEL SEAN OCONNOR D.O., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 EUCLID AVE
CLEVELAND OH
44195-0001
US
IV. Provider business mailing address
6000 W CREEK RD SUITE 10
INDEPENDENCE OH
44131-2139
US
V. Phone/Fax
- Phone: 800-223-2273
- Fax:
- Phone: 216-986-1314
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: