Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | C1-0003896 | DE |
NPI | 1023089489 |
---|---|
Provider Name | Dr. Stefan S. O'connor |
First Address | Wilmington, DE 19803-2711 |
Second Address | Wilmington, DE 19808-5536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 20/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000415101 | (05) | DE |
0000415101 | DELAWARE PHYSICIANS CARE (01) | DE |
0560630000 | KEYSTONE/AMERIHEALTH (01) | DE |
4344682 | AETNA (01) | DE |
510390465 | BLUE CROSS BLUE SHIELD (01) | DE |
510390465 | CIGNA (01) | DE |
F27387 | (02) | DE |