Provider Demographics
NPI:1114925401
Name:NEEL, MICHAEL FOSTER (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FOSTER
Last Name:NEEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 LEWIS BAY RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5235
Mailing Address - Country:US
Mailing Address - Phone:774-552-6050
Mailing Address - Fax:774-552-6962
Practice Address - Street 1:43 LEWIS BAY RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5235
Practice Address - Country:US
Practice Address - Phone:774-552-6050
Practice Address - Fax:774-552-6962
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9137207V00000X
MA158781207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156897401Medicaid
8A2160Medicare ID - Type Unspecified