Provider Demographics
NPI:1942427885
Name:DAVID M O'NEIL MD PA
Entity Type:Organization
Organization Name:DAVID M O'NEIL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-391-1000
Mailing Address - Street 1:17 FONTANA LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3042
Mailing Address - Country:US
Mailing Address - Phone:410-391-1000
Mailing Address - Fax:410-391-0943
Practice Address - Street 1:17 FONTANA LN
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3042
Practice Address - Country:US
Practice Address - Phone:410-391-1000
Practice Address - Fax:410-391-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7300Medicare ID - Type Unspecified