MEDICARE: JOHANNA R O'NEILL 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	35-07-2272-O	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160047546	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730162710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA R O'NEILL MD

Provider Business Mailing Address
First Line	:	PO BOX 638269
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-8269
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18181 PEARL RD
Second Line	:	B206
City	:	STRONGSVILLE
State	:	OH
Zip	:	44136-6949
Country	:	US
Telephone Number	:	440-816-4930
Fax Number	:

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	01/19/2021

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