Provider Demographics
NPI:1326698168
Name:NEFF, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:NEFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX
Mailing Address - Street 2:
Mailing Address - City:GENOA
Mailing Address - State:NV
Mailing Address - Zip Code:89411-0083
Mailing Address - Country:US
Mailing Address - Phone:978-239-4940
Mailing Address - Fax:
Practice Address - Street 1:2871 CLOUDBURST CANYON DRIVE
Practice Address - Street 2:SUITE 83
Practice Address - City:GENOA
Practice Address - State:NV
Practice Address - Zip Code:89411-0083
Practice Address - Country:US
Practice Address - Phone:978-239-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program