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NPI Code Detail

MEDICARE: JOANN E MCNEAL PA-C

MEDICARE: JOANN E MCNEAL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-00807NC

General Provider Information

NPI Number : 1053445635
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANN E MCNEAL PA-C
Provider Business Mailing Address
First Line : 178 LIVE OAK CHURCH RD
Second Line :
City : SELMA
State : NC
Zip : 27576-6453
Country : US
Telephone Number : 919-202-5773
Fax Number :
Provider Business Practice Location Address
First Line : 10 SUNNYBROOK RD
Second Line :
City : RALEIGH
State : NC
Zip : 27610-1808
Country : US
Telephone Number : 919-250-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 01/22/2009

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