Provider Demographics
NPI:1962777094
Name:BRASSARD, NEAL ANDREW (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:ANDREW
Last Name:BRASSARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6005-DEPT 196
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6005
Mailing Address - Country:US
Mailing Address - Phone:317-614-9817
Mailing Address - Fax:317-614-9655
Practice Address - Street 1:8040 CLEARVISTA PKWY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5630
Practice Address - Country:US
Practice Address - Phone:317-621-2000
Practice Address - Fax:317-614-9655
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074932A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology