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General NPI Number Information
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NPI Number | 1417954025
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Entity Type | Individual
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Provider Name | WALTER NEAL JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 725 OAKRIDGE BLVD STE C-1
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City | LUMBERTON
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State | NC
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Zip | 28358-2375
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Country | US
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Telephone | 910-608-3078
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Fax | 910-608-3079
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Provider Business Mailing Address
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Address Line | 2600 N ELM ST
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City | LUMBERTON
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State | NC
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Zip | 28358-3011
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Country | US
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Telephone | 910-272-3051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 18128
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License Number State | NC
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