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NPI Code Detail

MEDICARE: EDWARD O'BRIEN M.D.

MEDICARE: EDWARD O'BRIEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085B0100XBody Imaging Physician03604249IL
22085B0100XBody Imaging PhysicianMO31097MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174527584
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD O'BRIEN M.D.
Provider Business Mailing Address
First Line : PO BOX 23340
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63156-3340
Country : US
Telephone Number : 314-851-1000
Fax Number : 314-851-4477
Provider Business Practice Location Address
First Line : 9930 WATSON RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63126-1827
Country : US
Telephone Number : 314-984-8827
Fax Number : 314-984-0736
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/01/2008

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Directions to “ EDWARD O'BRIEN M.D.” Practice Location

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