Healthcare Provider Details

I. General information

NPI: 1295719094
Provider Name (Legal Business Name): DANIEL A NEUMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5818 HARBOUR VIEW BLVD SUITE 240
SUFFOLK VA
23435
US

IV. Provider business mailing address

5818 HARBOUR VIEW BLVD SUITE 240
SUFFOLK VA
23435
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-6100
  • Fax: 757-483-2203
Mailing address:
  • Phone: 757-483-6100
  • Fax: 757-483-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number101234465
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: