MEDICARE: DR. JAMES E NEAL M.D.

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	174400000X	Specialist	19523	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	61910	OTHER	NC	BC/BS

General Provider Information

NPI Number	:	1326013905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E NEAL M.D.

Provider Business Mailing Address
First Line	:	1072 X RAY DR
Second Line	:	SUITE B
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-864-0315
Fax Number	:	704-864-8994

Provider Business Practice Location Address
First Line	:	1072 X RAY DR
Second Line	:	SUITE B
City	:	GASTONIA
State	:	NC
Zip	:	28054-7488
Country	:	US
Telephone Number	:	704-864-0315
Fax Number	:	704-864-8994

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	07/09/2007

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