Provider Demographics
NPI:1780691261
Name:O'CONNELL, DANIEL J (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:O'CONNELL
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 1:18 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1021
Mailing Address - Country:US
Mailing Address - Phone:508-698-0011
Mailing Address - Fax:508-698-5373
Practice Address - Street 1:18 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1021
Practice Address - Country:US
Practice Address - Phone:508-698-0011
Practice Address - Fax:508-698-5373
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
405503OtherRIBCHIP
MAB20143401OtherCIGNA
0700907OtherUHC
MA13048OtherHPHC
MA37802OtherFALLON
MA0113328Medicaid
MA045841OtherTUFTS
MAC18114OtherMABC
0700907OtherUHC
MAC18114Medicare ID - Type Unspecified