Healthcare Provider Details

I. General information

NPI: 1831285998
Provider Name (Legal Business Name): NEIL USPAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105
US

IV. Provider business mailing address

THIRTY-FOURTH STREET AND CIVIC CENTER BOULEVARD
PHILADELPHIA PA
19104
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-6015
  • Fax: 206-729-3070
Mailing address:
  • Phone: 240-676-6078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD60223819
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: