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NPI 1639871080

NPI 1639871080 : MARGARET O'BRIEN MD : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1639871080
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    Entity Type          |    Individual 
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    Provider Name        |    MARGARET O'BRIEN MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2023
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    Last Update Date     |    07/09/2024
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Provider Practice Location Address
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    Address Line         |    3401 N BROAD ST FL B5 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19140-5189
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    Country              |    US
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    Telephone            |    215-707-3376
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3401 N BROAD ST FL B5 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19140-5189
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    MT229719
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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