Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD12556 | OR |
NPI | 1134103252 |
---|---|
Provider Name | Michael C Oneil JR. |
First Address | Roseburg, OR 97471-2608 |
Second Address | Roseburg, OR 97471-1206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 22/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223446 | (05) | OR |
C93446 | (02) |