Healthcare Provider Details

I. General information

NPI: 1255581021
Provider Name (Legal Business Name): THOMAS AUGUSTINE NEAL II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W PERIMETER RD
ANDREWS AFB MD
20762-6601
US

IV. Provider business mailing address

1050 W PERIMETER RD
ANDREWS AFB MD
20762-6601
US

V. Phone/Fax

Practice location:
  • Phone: 240-857-4530
  • Fax:
Mailing address:
  • Phone: 240-857-4530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101043280
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0101043280
License Number StateVA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: