Provider Demographics
NPI:1265417406
Name:CARL, NEAL H (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:H
Last Name:CARL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2500 GASKINS ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238
Mailing Address - Country:US
Mailing Address - Phone:804-774-7099
Mailing Address - Fax:888-908-6676
Practice Address - Street 1:2500 GASKINS ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238
Practice Address - Country:US
Practice Address - Phone:804-774-7099
Practice Address - Fax:888-908-6676
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2018-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101102633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1265417406OtherANTHEM
VA7836242OtherAETNA
VA200044896220OtherCIGNA
VAG96989Medicare UPIN