Provider Demographics
NPI:1366429011
Name:O'BRIEN, MARIA LISA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LISA
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:LISA
Other - Last Name:DELIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:41680 MISS BESSIE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2965
Mailing Address - Country:US
Mailing Address - Phone:301-997-0055
Mailing Address - Fax:301-997-0066
Practice Address - Street 1:41680 MISS BESSIE DR STE 301
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2965
Practice Address - Country:US
Practice Address - Phone:301-997-0055
Practice Address - Fax:301-997-0066
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25649207Q00000X
CAC53909207Q00000X
MDD82534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine