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General NPI Number Information
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NPI Number | 1871600254
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Entity Type | Individual
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Provider Name | GREGORY SCOTT O'NEILL MD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 2 LIVEWELL DR
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City | KENNEBUNK
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State | ME
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Zip | 04043
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Country | US
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Telephone | 207-467-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DR
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City | BIDDEFORD
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State | ME
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Zip | 04005-9422
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Country | US
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Telephone | 207-467-6900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-084531
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 48511
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD20428
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License Number State | ME
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