MEDICARE: DOUGLAS A. NEELD MD

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
1	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	01034136A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000541477	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1780669374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS A. NEELD MD

Provider Business Mailing Address
First Line	:	11109 PARKVIEW PLAZA DR # 117
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11104 PARKVIEW CIRCLE DR STE 10
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1733
Country	:	US
Telephone Number	:	260-425-6070
Fax Number	:	260-425-6073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	04/02/2025

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Directions to “ DOUGLAS A. NEELD MD” Practice Location

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