Provider Demographics
NPI:1881890648
Name:MARU, NEAL KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:KEVIN
Last Name:MARU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 419402
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-9402
Mailing Address - Country:US
Mailing Address - Phone:855-290-1552
Mailing Address - Fax:866-787-9747
Practice Address - Street 1:6355 WALKER LANE, 313
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310
Practice Address - Country:US
Practice Address - Phone:703-313-9111
Practice Address - Fax:703-313-4945
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012531332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty