Provider Demographics
NPI:1598749954
Name:NEUMAN, NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:
Last Name:NEUMAN
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 1:300 HEALTH WAY DR
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-1420
Mailing Address - Country:US
Mailing Address - Phone:573-438-2977
Mailing Address - Fax:573-438-1252
Practice Address - Street 1:300 HEALTH WAY DR
Practice Address - Street 2:
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664-1420
Practice Address - Country:US
Practice Address - Phone:573-438-2977
Practice Address - Fax:573-438-1252
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-052282208800000X
MO33428208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036052282Medicaid
MO201039609Medicaid
IL340006499Medicare PIN
IL036052282Medicaid
MO340015639Medicare PIN
MO201039609Medicaid
MO003011362Medicare PIN