Provider Demographics
NPI:1639354566
Name:BAESEL, NEIL ALLEN (OMD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ALLEN
Last Name:BAESEL
Suffix:
Gender:M
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S WELLS AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1612
Mailing Address - Country:US
Mailing Address - Phone:775-324-4008
Mailing Address - Fax:775-324-4006
Practice Address - Street 1:300 S WELLS AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1612
Practice Address - Country:US
Practice Address - Phone:775-324-4008
Practice Address - Fax:775-324-4006
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1024171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist