Provider Demographics
NPI:1073596151
Name:NEALE, DONNA M (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:NEALE
Suffix:
Gender:F
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:PO BOX 64313
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4313
Mailing Address - Country:US
Mailing Address - Phone:410-955-6700
Mailing Address - Fax:
Practice Address - Street 1:11065 LITTLE PATUXENT PKWY
Practice Address - Street 2:CENTER FOR MATERNAL AND FETAL MEDICINE
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2998
Practice Address - Country:US
Practice Address - Phone:410-740-7903
Practice Address - Fax:410-720-8999
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT037997207VM0101X
MDD48111207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001379975Medicaid
MD845126501Medicaid
MD845126501Medicaid
CT160001802Medicare UPIN
CT001379975Medicaid