Provider Demographics
NPI:1366709545
Name:NEIHEISEL, PHILIP ARLIS (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:ARLIS
Last Name:NEIHEISEL
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 1:132 SYLVA PLZ
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5252
Mailing Address - Country:US
Mailing Address - Phone:828-586-2377
Mailing Address - Fax:828-586-5888
Practice Address - Street 1:132 SYLVA PLZ
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5252
Practice Address - Country:US
Practice Address - Phone:828-586-2377
Practice Address - Fax:828-586-5888
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01447207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine