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General NPI Number Information
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NPI Number | 1134137623
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Entity Type | Individual
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Provider Name | STEPHEN J O' CONNOR MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 295 MIDLAND PKWY
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City | SUMMERVILLE
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State | SC
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Zip | 29483
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Country | US
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Telephone | 843-832-5160
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Fax |
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Provider Business Mailing Address
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Address Line | 6880 W SNOWVILLE RD SUITE #210
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City | BRECKSVILLE
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State | OH
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Zip | 44141-3254
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Country | US
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Telephone | 800-261-0048
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Fax | 440-526-2850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 26592
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License Number State | SC
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