Provider Demographics
NPI:1124190996
Name:MEADE, NEIL A (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:A
Last Name:MEADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6501 LANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1414
Mailing Address - Country:US
Mailing Address - Phone:301-772-1133
Mailing Address - Fax:
Practice Address - Street 1:9811 MALLARD DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3143
Practice Address - Country:US
Practice Address - Phone:301-953-1020
Practice Address - Fax:301-953-7918
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0406896Medicare ID - Type Unspecified
B92722Medicare UPIN