Provider Demographics
NPI:1265439509
Name:ONEAL, JANET KAYE (DO)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:KAYE
Last Name:ONEAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:KAYE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9709 STONEYBROOK DRIVE
Mailing Address - Street 2:OFFICE AND RESIDENCE
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3146
Mailing Address - Country:US
Mailing Address - Phone:301-589-7441
Mailing Address - Fax:301-495-8991
Practice Address - Street 1:9709 STONEYBROOK DRIVE
Practice Address - Street 2:OFFICE AND RESIDENCE
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3146
Practice Address - Country:US
Practice Address - Phone:301-589-7441
Practice Address - Fax:301-495-8991
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0043745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD374502300Medicaid
MD31380001OtherCAREFIRST
G01751M01Medicare PIN
F68267Medicare UPIN
MDG01751M01Medicare PIN
MDF68267Medicare UPIN