Provider Demographics
NPI:1023865292
Name:O'NEAL, ERIC (WHNP-BC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 BRUNSWICK ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MD
Mailing Address - Zip Code:21716-1129
Mailing Address - Country:US
Mailing Address - Phone:443-803-4073
Mailing Address - Fax:
Practice Address - Street 1:1165 IMPERIAL DR STE 300
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6556
Practice Address - Country:US
Practice Address - Phone:301-665-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR238397363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health