MEDICARE: DR. JULIE NEELY 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	207R00000X	Internal Medicine Physician	0101054966	VA

General Provider Information

NPI Number	:	1881657997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE NEELY M.D.

Provider Business Mailing Address
First Line	:	634 SHAWNEE TRL
Second Line	:
City	:	BLACKSBURG
State	:	VA
Zip	:	24060-8858
Country	:	US
Telephone Number	:	540-951-7236
Fax Number	:

Provider Business Practice Location Address
First Line	:	CHARLES W. SCHIFFERT HEALTH CENTER
Second Line	:	MCCOMAS HALL (0140)
City	:	BLACKSBURG
State	:	VA
Zip	:	24061-0001
Country	:	US
Telephone Number	:	540-231-5230
Fax Number	:

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/08/2007

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