Individual
DR. WALTER M O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19415 DEERFIELD AVENUE, SUITE 112, LEESBURG, VA 20176-8470
(703) 724-1195
(703) 724-4495
Mailing address
9815 SPRING RIDGE LN, VIENNA, VA 22182-1453
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101038671
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730173360
—
VA
01
—
340017880
RRMEDICARE
VA
01
—
340018240
RR MEDICARE
DC
05
—
7503300
—
VA
05
—
7503326
—
VA
Enumeration date
09/09/2005
Last updated
01/10/2024
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