Provider Demographics
NPI:1811929037
Name:ONEILL, CARA MP (MD)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:MP
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:MARIE
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:NINE MED PARK
Mailing Address - Street 2:SUITE 200A UNIV PEDIATRICS
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-7950
Mailing Address - Fax:803-434-3855
Practice Address - Street 1:FOURTEEN MEDICAL PARK
Practice Address - Street 2:SUITE 400
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7950
Practice Address - Fax:803-434-3855
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23911174400000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC$$$$$$$$$OtherSSN
SCGP0219Medicaid
SC23911OtherSC MEDICAL LIC #
SCI07170Medicare UPIN