MEDICARE: DR. NEAL ANDREW NAITO

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	207R00000X	Internal Medicine Physician	29054	WI

General Provider Information

NPI Number	:	1174515530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL ANDREW NAITO

Provider Business Mailing Address
First Line	:	7125 COLLINGWOOD CT
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-5548
Country	:	US
Telephone Number	:	410-747-8168
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 JONES BRIDGE RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4712
Country	:	US
Telephone Number	:	301-295-9773
Fax Number	:

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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