MEDICARE: DONNA MARIE O'CONNELL MD

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	208000000X	Pediatrics Physician	220156	MA

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	:	1942291497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARIE O'CONNELL MD

Provider Business Mailing Address
First Line	:	4 WISTERIA DR
Second Line	:
City	:	PLAINVILLE
State	:	MA
Zip	:	02762-1545
Country	:	US
Telephone Number	:	508-643-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 WASHINGTON ST
Second Line	:
City	:	NORWOOD
State	:	MA
Zip	:	02062-3487
Country	:	US
Telephone Number	:	781-769-4000
Fax Number	:

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	07/08/2007

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