Provider Demographics
NPI:1174515530
Name:NAITO, NEAL ANDREW
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ANDREW
Last Name:NAITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NEAL
Other - Middle Name:ANDREW
Other - Last Name:NAITO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7125 COLLINGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5548
Mailing Address - Country:US
Mailing Address - Phone:410-747-8168
Mailing Address - Fax:
Practice Address - Street 1:4301 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4712
Practice Address - Country:US
Practice Address - Phone:301-295-9773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine