Provider Demographics
NPI:1437114840
Name:MCNEEL, MICHAEL JEFFERY (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEFFERY
Last Name:MCNEEL
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 1:823 CAMPBELL HILL ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1144
Mailing Address - Country:US
Mailing Address - Phone:770-425-0118
Mailing Address - Fax:770-426-1626
Practice Address - Street 1:823 CAMPBELL HILL ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1144
Practice Address - Country:US
Practice Address - Phone:770-425-0118
Practice Address - Fax:770-426-1626
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035096208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA13-00999OtherUHC
GAG55683Medicare UPIN
GA24BCBNGMedicare ID - Type Unspecified