Provider Demographics
NPI:1265438204
Name:MCNEER, MARY TAYLOR (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:TAYLOR
Last Name:MCNEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1603 SANTA ROSA RD
Mailing Address - Street 2:RM 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5010
Mailing Address - Country:US
Mailing Address - Phone:804-288-6750
Mailing Address - Fax:804-288-6753
Practice Address - Street 1:7605 FOREST AVE
Practice Address - Street 2:STE 109
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4938
Practice Address - Country:US
Practice Address - Phone:804-285-6390
Practice Address - Fax:804-285-6393
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236234207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
137110OtherANTHEM
VA48670OtherCARENET
VA010066263Medicaid
VA240770OtherSOUTHERN HEALTH
VA4124852OtherMAMSI
VA7115503OtherAETNA
VA2406266OtherUNITED HEALTHCARE
VA7681067OtherCIGNA
VA240770OtherSOUTHERN HEALTH
VA4124852OtherMAMSI