Provider Demographics
NPI:1740290824
Name:GEORGE B NEAL MD PC
Entity type:Organization
Organization Name:GEORGE B NEAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-472-8624
Mailing Address - Street 1:18 CONSTITUTION DRIVE
Mailing Address - Street 2:UNIT 6
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110
Mailing Address - Country:US
Mailing Address - Phone:603-472-8624
Mailing Address - Fax:603-472-9146
Practice Address - Street 1:18 CONSTITUTION DRIVE
Practice Address - Street 2:UNIT 6
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-472-8624
Practice Address - Fax:603-472-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH69562084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E60911OtherHARVARD
010279440NH01OtherANTHEM
2022OtherCIGNA
3027807OtherAETNA
E60911Medicare UPIN
010279440NH01OtherANTHEM