Individual
MARK E OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 M 139, BENTON HARBOR, MI 49022-3881
(269) 927-5400
(269) 927-5493
Mailing address
50 INDUSTRIAL PARK DRIVE, BANGOR, MI 49013
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080677
MI
208000000X
Pediatrics Physician
4301080677
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4605349
—
MI
Enumeration date
07/05/2006
Last updated
01/07/2013
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