Individual
TADEO E O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1840 GATOR BLVD, VIRGINIA BEACH, VA 23459-8931
(757) 202-1362
Mailing address
1840 GATOR BLVD, VIRGINIA BEACH, VA 23459-8931
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/01/2008
Last updated
09/14/2011
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