Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301049030 | MI |
N | 207VG0400X | Gynecologist | 4301049030 | MI |
NPI | 1053358556 |
---|---|
Provider Name | Samuel Gene Mcneeley |
First Address | Chicago, IL 60689-5323 |
Second Address | Detroit, MI 48201-1461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 18/02/2009 |