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Individual

MARY CLAIRE OBRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
009801427
NC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
009801427
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13346
BCBS
NC
05
2004963000
WV
01
7661638
AETNA
NC
01
802686
PARTNERS
NC
05
8913346
NC
05
9999922
VA
01
C5232
MEDCOST
NC
05
Q01427
SC
Enumeration date
12/13/2005
Last updated
08/11/2010
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