Provider Demographics
NPI:1922402395
Name:NEAL, ROBERT ROSS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ROSS
Last Name:NEAL
Suffix:JR
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 1:7917 WYOMING CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1092
Mailing Address - Country:US
Mailing Address - Phone:952-941-5429
Mailing Address - Fax:
Practice Address - Street 1:7917 WYOMING CT
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1092
Practice Address - Country:US
Practice Address - Phone:952-941-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20210207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology