Provider Demographics
NPI:1376553552
Name:MCNEIL, GEORGE N (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:N
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CHADWICK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-3214
Mailing Address - Country:US
Mailing Address - Phone:207-662-2221
Mailing Address - Fax:207-662-6783
Practice Address - Street 1:131 CHADWICK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3214
Practice Address - Country:US
Practice Address - Phone:207-662-2221
Practice Address - Fax:207-662-6783
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME74932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME09125701Medicare PIN
C66635Medicare UPIN
ME91257Medicare PIN