Provider Demographics
NPI:1821006248
Name:O'CONNELL, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10777 NALL AVE
Mailing Address - Street 2:#220
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1362
Mailing Address - Country:US
Mailing Address - Phone:913-469-0110
Mailing Address - Fax:913-469-6579
Practice Address - Street 1:10777 NALL AVE
Practice Address - Street 2:#220
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1362
Practice Address - Country:US
Practice Address - Phone:913-469-0110
Practice Address - Fax:913-469-6579
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0424071207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B75082Medicare UPIN
K282183Medicare ID - Type Unspecified