Provider Demographics
NPI:1245237858
Name:NEEB, NORMAN C (DO)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:C
Last Name:NEEB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-0073
Mailing Address - Country:US
Mailing Address - Phone:314-984-0033
Mailing Address - Fax:314-991-8960
Practice Address - Street 1:12166 OLD BIG BEND RD
Practice Address - Street 2:STE. 108
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6844
Practice Address - Country:US
Practice Address - Phone:314-984-0033
Practice Address - Fax:314-984-0020
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-29
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR1J92208D00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO180821OtherBLUE CROSS BLUE SHIELD
MO4585451OtherAETNA PROVIDER NUMBER
MO133154OtherHEALTHLINK PROVIDER NUMBE
MO242604312Medicaid
MO431554207OtherMERCY HEALTH PLAN
MO2300025OtherUNITED HEALTH CARE PROV #