Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | R1J92 | MO |
N | 208D00000X | General Practice Physician | R1J92 | MO |
NPI | 1245237858 |
---|---|
Provider Name | Dr. Norman C Neeb |
First Address | Maryland Heights, MO 63043-0073 |
Second Address | Kirkwood, MO 63122-6844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2005 |
Last Update Date | 23/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133154 | HEALTHLINK PROVIDER NUMBE (01) | MO |
180821 | BLUE CROSS BLUE SHIELD (01) | MO |
2300025 | UNITED HEALTH CARE PROV # (01) | MO |
242604312 | (05) | MO |
431554207 | MERCY HEALTH PLAN (01) | MO |
4585451 | AETNA PROVIDER NUMBER (01) | MO |
E69192 | (02) | MO |