Provider Demographics
NPI:1174985303
Name:DAVID R. NEFF, DO, PLLC
Entity type:Organization
Organization Name:DAVID R. NEFF, DO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-339-5489
Mailing Address - Street 1:6260 TIMBER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9319
Mailing Address - Country:US
Mailing Address - Phone:517-339-5489
Mailing Address - Fax:517-481-3785
Practice Address - Street 1:5680 MARSH RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-8987
Practice Address - Country:US
Practice Address - Phone:517-339-5489
Practice Address - Fax:517-481-3765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-26
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE7064V261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1518820Medicaid
MI1518820Medicaid