Provider Demographics
NPI:1548246341
Name:MCNEILL, DOUGLAS HUGH (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:HUGH
Last Name:MCNEILL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1721 TAUSSIG BOULEVARD
Mailing Address - Street 2:BRANCH HEALTH CLINIC - NAVAL STATION NORFOLK
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23511-2298
Mailing Address - Country:US
Mailing Address - Phone:757-953-8760
Mailing Address - Fax:757-953-8978
Practice Address - Street 1:1721 TAUSSIG BOULEVARD
Practice Address - Street 2:BRANCH HEALTH CLINIC - NAVAL STATION NORFOLK
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-2298
Practice Address - Country:US
Practice Address - Phone:757-953-8760
Practice Address - Fax:757-953-8978
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARN6550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB18097Medicare UPIN