Provider Demographics
NPI:1992986772
Name:O'BRIEN FAMILY CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:O'BRIEN FAMILY CHIROPRACTIC CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-268-8496
Mailing Address - Street 1:1912 LINCOLN DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4119
Mailing Address - Country:US
Mailing Address - Phone:410-268-8496
Mailing Address - Fax:410-268-4856
Practice Address - Street 1:1912 LINCOLN DR
Practice Address - Street 2:SUITE E
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4119
Practice Address - Country:US
Practice Address - Phone:410-268-8496
Practice Address - Fax:410-268-4856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01472261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD937MOtherMEDICARE GROUP NUMBER
MD01472PTOtherSTATE LISENCE
MD990AOtherCAREFIRST
MD2135935OtherALLIANCE MAMSI MDIPA
DCW32600001OtherCAREFIRST NCA
MD937MMedicare PIN
DCW32600001OtherCAREFIRST NCA