Organization
MICHAEL OBRIEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY EVANS (BILLING SUPERVISOR)
(208) 367-2802
Entity
Organization
Contact information
Practice address
901 N CURTIS RD, SUITE 101, BOISE, ID 83706-1338
(208) 367-2802
(208) 375-8755
Mailing address
901 N CURTIS RD, SUITE 101, BOISE, ID 83706-1338
(208) 367-2802
(208) 375-8755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M2977
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002425500
—
ID
Enumeration date
08/14/2008
Last updated
08/19/2008
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