Provider Demographics
NPI:1982612123
Name:NEAL, CHRISTOPHER ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:NEAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 KINOOLE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3868
Mailing Address - Country:US
Mailing Address - Phone:808-969-8010
Mailing Address - Fax:903-663-7394
Practice Address - Street 1:688 KINOOLE ST STE 103
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3868
Practice Address - Country:US
Practice Address - Phone:808-969-8010
Practice Address - Fax:903-663-7394
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD64142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI036937Medicaid
HIE69694Medicare UPIN
HIH56197Medicare PIN
HI036937Medicaid