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General NPI Number Information
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NPI Number | 1992805253
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Entity Type | Individual
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Provider Name | PETER D O'CONNOR M.D., O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 331 MAINE ST STE 4
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City | BRUNSWICK
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State | ME
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Zip | 04011-3359
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Country | US
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Telephone | 207-721-0911
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Fax | 207-725-7910
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Provider Business Mailing Address
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Address Line | 3551 ROGER BROOKE DR DOS - DEPARTMENT OF OTOLARYNGOLOGY
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City | SAN ANTONIO
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-2367
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0101238624
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207YS0012X
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Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
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License Number | 0101238624
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD24017
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License Number State | ME
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