# MARK S OBRIEN MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609018233
- **Authorized official:** DR. MARK STEVEN OBRIEN MD (MANAGER)
- **Authorized official phone:** (616) 774-8200

## Contact information

- **Practice address:** 4070 LAKE DR SE, SUITE 201, GRAND RAPIDS, MI 49546-8294
- **Practice address phone:** (616) 774-8200
- **Practice address fax:** (616) 774-0304
- **Mailing address:** 4070 LAKE DR SE, SUITE 201, GRAND RAPIDS, MI 49546-8294
- **Mailing address phone:** (616) 774-8200
- **Mailing address fax:** (616) 774-0304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301048187 | MI | Yes |

## Other

- **Enumeration date:** 03/27/2009
- **Last updated:** 10/24/2012