Provider Demographics
NPI:1144237553
Name:MCNEIL, DEANNA SIMMONS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:SIMMONS
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:MICHELE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:413 BRIDGECREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8904
Mailing Address - Country:US
Mailing Address - Phone:803-788-1430
Mailing Address - Fax:
Practice Address - Street 1:2015 MARION ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2113
Practice Address - Country:US
Practice Address - Phone:803-898-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC164392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC164397Medicaid