Provider Demographics
NPI:1225064421
Name:NEEB, ANDREW DAVID (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:NEEB
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 1:431 NE REVERE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4192
Mailing Address - Country:US
Mailing Address - Phone:541-508-7973
Mailing Address - Fax:541-508-7968
Practice Address - Street 1:431 NE REVERE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4192
Practice Address - Country:US
Practice Address - Phone:541-508-7973
Practice Address - Fax:541-508-7968
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD26682208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD26682OtherOR LIC NUMBER