=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487617387
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NORMAN M. NECHES M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 12/26/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10719 MCGREGOR DR
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21044-4956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-365-7144
-----------------------------------------------------
Fax | 301-424-5699
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10719 MCGREGOR DR
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21044-4956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-365-7144
-----------------------------------------------------
Fax | 301-424-5699
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 103727
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------