| Michael J. O'connell D.o. Inc | |
|
17960 Cleveland Road South Bend IN 46635 | |
| (574) 287-7205 | |
| (574) 232-5045 |
| Full Name | Michael J. O'connell D.o. Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 17960 Cleveland Road, South Bend, Indiana |
| Authorized Official Name and Position | Michael J O'connell (PHYSICIAN) |
| Authorized Official Contact | 5742877205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J. O'connell D.o. Inc 17960 Cleveland Road South Bend IN 46635 Ph: (574) 287-7205 | Michael J. O'connell D.o. Inc 17960 Cleveland Road South Bend IN 46635 Ph: (574) 287-7205 |
| NPI Number | 1225185739 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 01/21/2011 |
| Medicare PECOS PAC ID | 9133011125 |
|---|---|
| Medicare Enrollment ID | O20040325001105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225185739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02000569A (Indiana) | Primary |
| Provider Name | Michael James Oconnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083691885 PECOS PAC ID: 3678465689 Enrollment ID: I20100106000651 |
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