Individual
DR. BRENDAN O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4170
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20588
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718061
WV BCBS
WV
01
—
1060164
WV DWC
WV
01
—
1060167
WV DWC
WV
05
—
2001076000
—
WV
Enumeration date
12/19/2005
Last updated
11/13/2008
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