Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | D0031761 | MD |
Y | 207RX0202X | Medical Oncology | D31761 | MD |
NPI | 1174515050 |
---|---|
Provider Name | Dr. Brian O'connor |
First Address | Baltimore, MD 21297-3086 |
Second Address | Frederick, MD 21702-4337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 15/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28658979 | AETNA PVN (01) | |
523014-01 | CAREFIRST BCBS MARYLAND (01) | |
81961100 | (05) | MD |
971641 | UNITED (01) | |
E44525 | (02) | MD |
W575-0002 | CAREFIRST BCBS GHMSI (01) |