Provider Demographics
NPI:1891840856
Name:O'NEILL, PENELOPE H (MD)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:H
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL RD
Mailing Address - Street 2:CALL BOX C268
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-9253
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-1723
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9300263208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7964176Medicaid
NCF63519Medicare UPIN
NC7964176Medicaid