Provider Demographics
NPI:1720021421
Name:NEFF, MICHAEL SHAWN (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SHAWN
Last Name:NEFF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TRIPLER AMC ATTN:MCHK-QS
Mailing Address - City:TRIPLER AMC
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-2460
Mailing Address - Fax:808-433-1558
Practice Address - Street 1:4076 NEELY RD
Practice Address - Street 2:BASSET ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT WAINWRIGHT
Practice Address - State:AK
Practice Address - Zip Code:99703
Practice Address - Country:US
Practice Address - Phone:907-361-5322
Practice Address - Fax:907-361-4386
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIDOS-1097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN