Alfonso V O'Neill, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

AO043730 Issued in MI

Practice address

25631 Little Mack Ave Ste 202
Saint Clair Shores, MI 48081-2108

Phone

(586) 588-9813

Fax

(586) 588-9814

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1922054832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25631 LITTLE MACK AVE STE 202",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812108",
            "telephone_number": "586-588-9813",
            "fax_number": "586-588-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25631 LITTLE MACK AVE STE 202",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812108",
            "telephone_number": "586-588-9813",
            "fax_number": "586-588-9814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 RIDGE RD",
            "address_purpose": "LOCATION",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363544",
            "country_code": "US",
            "telephone_number": "586-588-9813",
            "fax_number": "586-588-9814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "ALFONSO",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "AO043730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193361310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Pulmonary Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.