Provider Demographics
NPI:1336362912
Name:NEAL, JAMES JAVON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JAVON
Last Name:NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:765 E ROUTE 70
Mailing Address - Street 2:BULDING A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2341
Mailing Address - Country:US
Mailing Address - Phone:856-983-3900
Mailing Address - Fax:
Practice Address - Street 1:765 E ROUTE 70
Practice Address - Street 2:BUILDING A
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2341
Practice Address - Country:US
Practice Address - Phone:856-983-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06356800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJOTH000Medicare UPIN