Provider Demographics
NPI:1992784359
Name:NEAL, JOHN W (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:NEAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:519 E LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5502
Mailing Address - Country:US
Mailing Address - Phone:910-276-1150
Mailing Address - Fax:910-277-1966
Practice Address - Street 1:519 LAUCHWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5502
Practice Address - Country:US
Practice Address - Phone:910-276-1150
Practice Address - Fax:910-277-1966
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC22313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
202304BMedicare PIN
NC202304Medicare PIN