Individual
MARK O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2409 CHERRY ST, STE 100, TOLEDO, OH 43608-2625
(419) 251-3700
(419) 251-3835
Mailing address
2409 CHERRY ST, STE 100, TOLEDO, OH 43608-2625
(419) 251-3700
(419) 251-3835
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
350721050
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000140670
ANTHEM
OH
01
—
02570
PARAMOUNT
OH
01
—
060056251
RAILROAD MEDICARE
OH
01
—
1105810672
BLUE CROSS BLUE SHIELD MICHIGAN
MI
05
—
2018846
—
OH
05
—
4140805
—
MI
Enumeration date
08/12/2005
Last updated
02/06/2009
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