Provider Demographics
NPI:1851339139
Name:O'ROURKE, EDWARD J (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:O'ROURKE
Suffix:
Gender:M
Credentials:MD
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Other - Suffix:
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Mailing Address - Street 1:31 WILDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1726
Mailing Address - Country:US
Mailing Address - Phone:617-388-4164
Mailing Address - Fax:
Practice Address - Street 1:641 HUNTINGTON AVENUE
Practice Address - Street 2:HARVARD MED SCHOOL - DEPT OF SOCIAL MED
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-388-4164
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA500532080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases