Healthcare Provider Details

I. General information

NPI: 1700846979
Provider Name (Legal Business Name): ALISON M NEAL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 N ROAD ST STE 2
ELIZABETH CITY NC
27909-3365
US

IV. Provider business mailing address

1134 N ROAD ST STE 2
ELIZABETH CITY NC
27909-3365
US

V. Phone/Fax

Practice location:
  • Phone: 252-335-2923
  • Fax: 252-335-7003
Mailing address:
  • Phone: 252-335-2923
  • Fax: 252-335-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number103477
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: