Provider Demographics
NPI:1164503058
Name:O'BRIEN, JEANNE E (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15001 SHADY GROVE RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6352
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:301-340-1612
Practice Address - Street 1:15001 SHADY GROVE RD
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6352
Practice Address - Country:US
Practice Address - Phone:301-340-1188
Practice Address - Fax:301-340-1612
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0064448207VE0102X
IL207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
199489OtherANTHEM
MD886940-01OtherCAREFIRST BCBS
0906-0020OtherCAREFIRST BCBS
2147646OtherMAMSI
260038OtherKAISER PERMANENTE
1257626OtherAETNA
756592OtherNCPPO
198489OtherANTHEM HEALTHKEEPERS
2147646OtherUNITEDHEALTHCARE
4161559OtherCIGNA
756592OtherNCPPO