MEDICARE: DR. BRENDAN B O'HARE 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
1	174400000X	Specialist	MD49536	TN

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	:	1669678116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENDAN B O'HARE M.D.

Provider Business Mailing Address
First Line	:	1115B DOW ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-2487
Country	:	US
Telephone Number	:	615-896-6996
Fax Number	:	615-896-6985

Provider Business Practice Location Address
First Line	:	1115B DOW ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-2487
Country	:	US
Telephone Number	:	615-896-6996
Fax Number	:	615-896-6985

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

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	11/15/2013

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