Provider Demographics
NPI:1881676435
Name:ONEILL, WILLIAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:ONEILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:K14 OFFICE B1417
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-1878
Mailing Address - Fax:313-916-2819
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:K14 OFFICE B1417
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1878
Practice Address - Fax:313-916-2819
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0097328207RI0011X
MI4301039889207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2772965-00Medicaid
FLAA352XOtherMEDICARE ID-TYPE UNSPECIFIED
E26897Medicare UPIN