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NPI Code Detail

MEDICARE: MARY T. O'BRIEN, MD, PLC

MEDICARE: MARY T. O'BRIEN, MD, PLC
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
1207Q00000XFamily Medicine Physician0101017504VA

General Provider Information

NPI Number : 1669501466
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARY T. O'BRIEN, MD, PLC
Provider Business Mailing Address
First Line : 422 COMMERCE RD
Second Line :
City : STAUNTON
State : VA
Zip : 24401-4432
Country : US
Telephone Number : 540-886-6086
Fax Number : 540-886-6918
Provider Business Practice Location Address
First Line : 422 COMMERCE RD
Second Line :
City : STAUNTON
State : VA
Zip : 24401-4432
Country : US
Telephone Number : 540-886-6086
Fax Number : 540-886-6918
Authorized Official
Title or Position : OWNER
Name : DR. MARY T. O'BRIEN
Credential : M.D.
Telephone Number : 540-886-6086
Provider Enumeration Date : 03/05/2007
Last Update Date : 01/16/2008

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