Individual
MICHAEL JEFFERY O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 793-7750
(770) 793-7755
Mailing address
1365 CLIFTON ROAD, ATLANTA, GA 30322-1064
(404) 778-7717
(404) 778-7466
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30175
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
30175
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000364339S
—
GA
01
—
1664446-015
CIGNA
GA
01
—
52025125-004
BLUE CHOICE
GA
01
—
5733463
AETNA
GA
Enumeration date
06/05/2006
Last updated
10/11/2019
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