Individual
BRIAN M O'NEILL
Active
Individual
BRIAN M O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-02-1069
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000127870
ANTHEM BC
OH
01
—
190010049
RR MEDICARE
OH
01
—
190010050
RR MEDICARE
OH
05
—
2171368
—
OH
Enumeration date
08/16/2005
Last updated
10/26/2016
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