Provider Demographics
NPI:1467552463
Name:NEALON, KEVIN G (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:G
Last Name:NEALON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5215 LOUGHBORO RD NW
Mailing Address - Street 2:STE 440
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2618
Mailing Address - Country:US
Mailing Address - Phone:202-237-2910
Mailing Address - Fax:202-237-2913
Practice Address - Street 1:5215 LOUGHBORO RD NW
Practice Address - Street 2:STE 440
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2618
Practice Address - Country:US
Practice Address - Phone:202-237-2910
Practice Address - Fax:202-237-2913
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD11240207R00000X
MDD0023127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B93943Medicare UPIN