Provider Demographics
NPI:1366455651
Name:NEUZIL, DANIEL F (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:F
Last Name:NEUZIL
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:PO BOX 64226
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4226
Mailing Address - Country:US
Mailing Address - Phone:667-214-1720
Mailing Address - Fax:410-328-2750
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD804952086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8226797Medicaid
WANE0297OtherBLUE SHIELD
WA0039588OtherLABOR & INDUSTRY
020039503OtherRAILROAD MEDICARE
WAMD7243WOtherALASKA MEDICAID
WAUS1042946OtherAETNA/USHC SPECIALIST
WAMD7243WOtherALASKA MEDICAID
WAUS1042946OtherAETNA/USHC SPECIALIST
WAAB06505Medicare PIN
020039503OtherRAILROAD MEDICARE
WAAB04169Medicare PIN