Healthcare Provider Details

I. General information

NPI: 1154394724
Provider Name (Legal Business Name): NEIL R SEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 M 62
CASSOPOLIS MI
49031-1034
US

IV. Provider business mailing address

261 M-62
CASSOPOLIS MI
49031-1023
US

V. Phone/Fax

Practice location:
  • Phone: 269-445-3874
  • Fax: 269-445-2076
Mailing address:
  • Phone: 269-445-3874
  • Fax: 269-445-2076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301035249
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: