Provider Demographics
NPI:1407933575
Name:O CONNOR, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:O CONNOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 341589
Mailing Address - Street 2:
Mailing Address - City:WEST BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20827-1589
Mailing Address - Country:US
Mailing Address - Phone:301-881-5167
Mailing Address - Fax:301-816-9576
Practice Address - Street 1:11125 ROCKVILLE PIKE
Practice Address - Street 2:STE. 308
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3142
Practice Address - Country:US
Practice Address - Phone:301-881-5167
Practice Address - Fax:301-816-9576
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD09499208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD05916Medicare UPIN
MD042927Medicare PIN