Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0022619 | MD |
NPI | 1154364529 |
---|---|
Provider Name | David M O'neil |
First Address | Baltimore, MD 21237-3042 |
Second Address | Baltimore, MD 21237-3042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 25/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
771421100 | MEDICAL ASSISTANCE (01) | MD |