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Individual
SEAN C O'BRIEN
Active
Individual
SEAN C O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
055.0031197
VT
363AM0700X
Medical Physician Assistant
0895
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000735
—
VT
Enumeration date
05/22/2012
Last updated
06/26/2015
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