Provider Demographics
NPI:1154329456
Name:ONEAL, KEVIN DANIEL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:DANIEL
Last Name:ONEAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARKWAY OFFICE CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7437
Mailing Address - Country:US
Mailing Address - Phone:919-322-1995
Mailing Address - Fax:919-827-1321
Practice Address - Street 1:100 PARKWAY OFFICE CT
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7437
Practice Address - Country:US
Practice Address - Phone:919-322-1995
Practice Address - Fax:919-827-1321
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79456207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC180042203OtherMEDICARE RR
7083038OtherAETNA
129MKOtherBCBS
A6882OtherMEDCOST
6919203OtherCIGNA
H35741Medicare UPIN
NC0614340001Medicare NSC
6919203OtherCIGNA
200100583Medicare ID - Type Unspecified
NC2285728Medicare PIN