Provider Demographics
NPI:1467521567
Name:TAUB, NEAL STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:STEPHEN
Last Name:TAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31741
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28231-1741
Mailing Address - Country:US
Mailing Address - Phone:704-442-9805
Mailing Address - Fax:704-405-0868
Practice Address - Street 1:3535 RANDOLPH RD
Practice Address - Street 2:SUITE 208
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1032
Practice Address - Country:US
Practice Address - Phone:704-442-9805
Practice Address - Fax:704-405-0868
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81743208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8981743Medicaid
NC8981743Medicaid
NCE93583Medicare UPIN
NC5851490001Medicare NSC