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General NPI Number Information
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NPI Number | 1356582571
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Entity Type | Individual
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Provider Name | MIECHELLE L. O'BRIEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 111 OSBORNE STREET- STE 121
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City | DANBURY
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State | CT
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Zip | 06810-6019
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Country | US
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Telephone | 203-739-7010
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Fax | 203-739-1517
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Provider Business Mailing Address
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Address Line | 111 OSBORNE STREET- STE 121
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City | DANBURY
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State | CT
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Zip | 06810-6019
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Country | US
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Telephone | 203-739-7010
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Fax | 203-739-1517
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 047450
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License Number State | CT
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