Provider Demographics
NPI:1407828254
Name:MCNEIL, JOHN IAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:IAN
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12126 HERITAGE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-4554
Mailing Address - Country:US
Mailing Address - Phone:301-460-6664
Mailing Address - Fax:301-460-7867
Practice Address - Street 1:12126 HERITAGE PARK CIR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-4554
Practice Address - Country:US
Practice Address - Phone:301-460-6664
Practice Address - Fax:301-460-7867
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0046584207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG01938M02Medicare ID - Type Unspecified
MDG33471Medicare UPIN