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General NPI Number Information
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NPI Number | 1720168172
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Entity Type | Individual
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Provider Name | MICHAEL J O'BRIEN MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 11600 W 2ND PL
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City | LAKEWOOD
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State | CO
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Zip | 80228-1527
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Country | US
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Telephone | 720-321-0000
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Fax | 720-321-1621
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Provider Business Mailing Address
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Address Line | PO BOX 223897
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City | PITTSBURGH
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State | PA
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Zip | 15251-2897
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Country | US
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Telephone | 303-433-9729
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Fax | 303-480-0405
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0046816
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | DR.0046816
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License Number State | CO
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