Provider Demographics
NPI:1295442515
Name:NEUMANN, MICHAEL A
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 COVES NORTH DR
Mailing Address - Street 2:
Mailing Address - City:BRANT LAKE
Mailing Address - State:SD
Mailing Address - Zip Code:57016-7510
Mailing Address - Country:US
Mailing Address - Phone:605-480-1391
Mailing Address - Fax:
Practice Address - Street 1:3671 COVES NORTH DR
Practice Address - Street 2:
Practice Address - City:BRANT LAKE
Practice Address - State:SD
Practice Address - Zip Code:57016-7510
Practice Address - Country:US
Practice Address - Phone:605-480-1391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR026018163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology