Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 0101041155 | VA |
N | 2086S0129X | Vascular Surgeon | 15629 | DC |
NPI | 1033107305 |
---|---|
Provider Name | Richard Francis Neville |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 24/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E95051 | (02) |