Provider Demographics
NPI:1932301421
Name:M H NEAL MD PC
Entity Type:Organization
Organization Name:M H NEAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MADALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BETEAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-422-9300
Mailing Address - Street 1:10533 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5734
Mailing Address - Country:US
Mailing Address - Phone:734-422-9300
Mailing Address - Fax:734-422-0907
Practice Address - Street 1:10533 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-5734
Practice Address - Country:US
Practice Address - Phone:734-422-9300
Practice Address - Fax:734-422-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMN032838207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM72630Medicare PIN