Individual
STEPHEN T OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 ELM ST, ENFIELD FAMILY MEDICINE STE 302, ENFIELD, CT 06082
(860) 741-3069
(860) 745-3864
Mailing address
113 ELM ST, STE 302, ENFIELD, CT 06082
(860) 741-3069
(860) 745-3864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
019445
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080135196
RAILROAD MEDICARE
CT
05
—
1962448050
—
CT
Enumeration date
06/20/2006
Last updated
01/02/2009
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