Provider Demographics
NPI:1114462439
Name:MCNEIL, PATRICK (RT(R))
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 INSPIRATION PKWY S
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:MN
Mailing Address - Zip Code:55003-1611
Mailing Address - Country:US
Mailing Address - Phone:651-226-1580
Mailing Address - Fax:
Practice Address - Street 1:921 INSPIRATION PKWY S
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:MN
Practice Address - Zip Code:55003-1611
Practice Address - Country:US
Practice Address - Phone:651-226-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4446632471C1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN444663OtherARRT