Individual
JOHN O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-8193
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1848
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704285734
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704285734
MI
Other
Enumeration date
04/21/2021
Last updated
11/02/2023
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