Individual
DR. MARK S O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 N ILLINOIS ST STE 250, CARMEL, IN 46032-3015
(317) 688-5300
(317) 688-5313
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037757A
IN
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
01037757A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200033390
—
IN
Enumeration date
09/25/2006
Last updated
01/06/2021
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