Provider Demographics
NPI:1891085122
Name:O'CONNELL, ERIK WESLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:WESLEY
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8560
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:100 CAMPUS AVE STE 201
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6049
Practice Address - Country:US
Practice Address - Phone:207-777-4459
Practice Address - Fax:207-777-4485
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2022-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEDO2941207RR0500X, 207RR0500X
390200000X
PAOT014168390200000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program