Provider Demographics
NPI:1255369369
Name:NEVELING, LANCE WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:WILLIAM
Last Name:NEVELING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:250 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1464
Mailing Address - Country:US
Mailing Address - Phone:856-795-1867
Mailing Address - Fax:
Practice Address - Street 1:600 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-3042
Practice Address - Country:US
Practice Address - Phone:856-854-1050
Practice Address - Fax:856-854-5325
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB069685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH87147Medicare UPIN