Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 009801427 | NC |
N | 207PE0004X | Emergency Medical Services | 009801427 | NC |
NPI | 1013992163 |
---|---|
Provider Name | Mary Claire Obrien |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 11/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13346 | BCBS (01) | NC |
2004963000 | (05) | WV |
7661638 | AETNA (01) | NC |
802686 | PARTNERS (01) | NC |
8913346 | (05) | NC |
9999922 | (05) | VA |
C5232 | MEDCOST (01) | NC |
Q01427 | (05) | SC |