Healthcare Provider Details

I. General information

NPI: 1780593087
Provider Name (Legal Business Name): CREIG JERMANE NEAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SEVEN HILLS ANNEX RD W # 200
WILSON NC
27893-3688
US

IV. Provider business mailing address

2224 VIOLET BLUFF CT
RALEIGH NC
27610-3151
US

V. Phone/Fax

Practice location:
  • Phone: 252-483-6150
  • Fax:
Mailing address:
  • Phone: 252-483-1904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number2026-16965-01
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: