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NPI Code Detail

MEDICARE: DR. PAUL NEAL DO

MEDICARE:  DR. PAUL  NEAL  DO
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
1207P00000XEmergency Medicine Physician322426LA
2207Q00000XFamily Medicine Physician02004648AIN
3207Q00000XFamily Medicine Physician5101016313MI
4207Q00000XFamily Medicine Physician322426LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21861463879OTHERMIBC BS MI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861463879
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL NEAL DO
Provider Business Mailing Address
First Line : 200 CORPORATE BLVD
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-3870
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 3906 N EUCLID AVE
Second Line :
City : BAY CITY
State : MI
Zip : 48706-2029
Country : US
Telephone Number : 989-667-1955
Fax Number : 989-667-1958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2006
Last Update Date : 06/11/2021

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Directions to “ DR. PAUL NEAL DO” Practice Location

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