Provider Demographics
NPI:1437185972
Name:O'CONOR, CAROLYN BAIER (MD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BAIER
Last Name:O'CONOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32060 LONG NECK RD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-6228
Mailing Address - Country:US
Mailing Address - Phone:302-947-1202
Mailing Address - Fax:
Practice Address - Street 1:32060 LONG NECK RD STE 501
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-6228
Practice Address - Country:US
Practice Address - Phone:302-947-1202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD34386207Q00000X, 208M00000X
DEC1-0026289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD166002100Medicaid
MD166002100Medicaid
00A560S62Medicare PIN