Individual
SHANE R ONEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SIVLEY RD SW, EM DEPT, HUNTSVILLE, AL 35801
(256) 265-9905
(256) 265-9910
Mailing address
PO BOX 11407, DRAWER 0314, BIRMINGHAM, AL 35246-0314
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00025931
AL
207Q00000X
Family Medicine Physician
Primary
MD25931
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009936306
—
AL
01
—
051523238
BCBS PROVIDER NUMBER
AL
05
—
051523238
—
AL
01
—
051523239
BCBS
AL
05
—
051523239
—
AL
01
—
4110622
BCBS
TN
01
—
7089556
AETNA
AL
Enumeration date
09/19/2005
Last updated
11/23/2020
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