Provider Demographics
NPI:1073708293
Name:NEAL, CHARLES A IV (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:A
Last Name:NEAL
Suffix:IV
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1701 HARDEE AVE SW
Mailing Address - Street 2:
Mailing Address - City:FORT MCPHERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30330-1062
Mailing Address - Country:US
Mailing Address - Phone:404-464-0414
Mailing Address - Fax:404-464-0410
Practice Address - Street 1:1701 HARDEE AVE SW
Practice Address - Street 2:
Practice Address - City:FORT MCPHERSON
Practice Address - State:GA
Practice Address - Zip Code:30330-1062
Practice Address - Country:US
Practice Address - Phone:404-464-0414
Practice Address - Fax:404-464-0410
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical