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General NPI Number Information
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NPI Number | 1952608051
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Entity Type | Individual
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Provider Name | NEILAND BAERWALD DPH
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Gender | Male
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 220 WEARS VALLEY RD
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City | PIGEON FORGE
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State | TN
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Zip | 37863-4215
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Country | US
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Telephone | 865-428-0629
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Fax |
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Provider Business Mailing Address
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Address Line | 2440 BLACK BEAR RIDGE WAY
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City | SEVIERVILLE
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State | TN
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Zip | 37862-8084
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Country | US
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Telephone | 865-908-7911
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9325
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3501
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26091728A
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License Number State | IN
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