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Individual

AUTUMN M O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4775 KNIGHTSBRIDGE BLVD, SUITE 207, COLUMBUS, OH 43214-4313
(614) 442-5557
(614) 442-1070
Mailing address
4775 KNIGHTSBRIDGE BLVD, SUITE 207, COLUMBUS, OH 43214-4313
(614) 442-5557
(614) 442-1070

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35071470
OH
208000000X
Pediatrics Physician
Primary
35.071470
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111048
OH
Enumeration date
01/18/2006
Last updated
07/02/2008
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