Provider Demographics
NPI:1669444337
Name:NEELAND, DAVID BLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BLAIR
Last Name:NEELAND
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 1:2055 NORMANDIE DR
Mailing Address - Street 2:108
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2732
Mailing Address - Country:US
Mailing Address - Phone:334-288-4624
Mailing Address - Fax:334-280-3628
Practice Address - Street 1:2055 NORMANDIE DR
Practice Address - Street 2:108
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2732
Practice Address - Country:US
Practice Address - Phone:334-288-4624
Practice Address - Fax:334-280-3628
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000079892085R0202X
FLME901642085R0202X
NC0000-209422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000058866OtherIDTF
AL009968475Medicaid
AL009945290Medicaid
AL009968495Medicaid
AL107019Medicaid
AL000045292Medicaid
AL107018Medicaid
AL000045290Medicaid
AL051504364OtherIDTF
AL009968485Medicaid
AL108194Medicaid
AL000058867OtherIDTF
AL000085896Medicaid
FL270024700Medicaid
AL000083515Medicaid
AL009965385Medicaid
AL009974205Medicaid
AL108460Medicaid
AL009968475Medicaid
AL000083515Medicaid
AL000085896Medicaid
AL108194Medicaid
AL108460Medicaid
AL000089616Medicare PIN