Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036093584 | IL |
N | 208600000X | Surgeon | 036093584 | IL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036-093584 | IL |
NPI | 1326034448 |
---|---|
Provider Name | Michael W Neumeister |
First Address | Springfield, IL 62794-9653 |
Second Address | Springfield, IL 62702-6700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 10/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036093584 | (05) | IL |
G49357 | (02) |