Individual
JOHN OCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0212076
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1204908
MEDICA
—
01
—
12861OC
BLUE CROSS BLUE SHIELD
MN
01
—
CP9020830003
PREFERRED ONE
—
Enumeration date
07/27/2006
Last updated
07/08/2007
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