MEDICARE: TERRENCE X O'BRIEN MD, MS, FACC

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
1	207RC0000X	Cardiovascular Disease Physician	16785	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1578671525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRENCE X O'BRIEN MD, MS, FACC

Provider Business Mailing Address
First Line	:	PO BOX 751461
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1461
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 RUTLEDGE ST STE 1201
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8903
Country	:	US
Telephone Number	:	843-792-2295
Fax Number	:	843-792-7771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	10/22/2020

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