Provider Demographics
NPI:1801892328
Name:NEIL, ANJI A (MD)
Entity type:Individual
Prefix:
First Name:ANJI
Middle Name:A
Last Name:NEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANJI
Other - Middle Name:A
Other - Last Name:NEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-335-5341
Practice Address - Street 1:2535 MAPLECREST RD
Practice Address - Street 2:STE 10
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2799
Practice Address - Country:US
Practice Address - Phone:563-421-3200
Practice Address - Fax:563-421-3206
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34197207Q00000X
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4796890003OtherDMERC
IA01J9OtherJOHN DEERE HEALTH PLAN
085896OtherHEALTH ALLIANCE
IA1214007Medicaid
207390OtherIOWA HEALTH SOLUTIONS
35152OtherWELLMARK BC/BS
P00094840Medicare ID - Type UnspecifiedRAILROAD MEDICARE
IAI10348Medicare PIN
H25380Medicare UPIN