MEDICARE: MELISSA GOLD O'NEAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	200300858	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C8684	OTHER	NC	MEDCOST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	13447	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1366411209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA GOLD O'NEAL MD

Provider Business Mailing Address
First Line	:	7100 COMMERCE WAY
Second Line	:	SUITE 180
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2829
Country	:	US
Telephone Number	:	615-465-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 MEDICAL DR
Second Line	:
City	:	WILLIAMSTON
State	:	NC
Zip	:	27892-2156
Country	:	US
Telephone Number	:	252-809-6341
Fax Number	:	252-809-6376

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/06/2022

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