Individual
DR. GERARD STEPHEN O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BROWN ST, CHESTERTOWN, MD 21620-1435
(410) 778-6303
(410) 778-6306
Mailing address
100 BROWN ST, CHESTERTOWN, MD 21620-1435
(410) 778-6303
(410) 778-6306
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D0030368
MD
207Q00000X
Family Medicine Physician
Primary
D0030368
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390710400
—
MD
01
—
39849601
BLUE CROSS RENDERING #
MD
01
—
KBH8
MD BLUE CROSS GROUP #
MD
01
—
W251
CAREFIRST GROUP #
DC
Enumeration date
05/23/2005
Last updated
06/05/2023
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