Provider Demographics
NPI:1891945952
Name:O'BRIEN, MICHAEL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7832 MAIN FALLS CIR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2426
Mailing Address - Country:US
Mailing Address - Phone:410-788-4262
Mailing Address - Fax:
Practice Address - Street 1:810 GLENEAGLES CT
Practice Address - Street 2:SUITE 207
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2203
Practice Address - Country:US
Practice Address - Phone:410-823-5483
Practice Address - Fax:410-823-5734
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD35703207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine