Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 27265 | NC |
NPI | 1053373654 |
---|---|
Provider Name | Dr. Demar Austin Neal |
First Address | Gastonia, NC 28054-2134 |
Second Address | Gastonia, NC 28054-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 28/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8962671 | (05) | NC |
C86497 | (02) | NC |