Provider Demographics
NPI:1861093718
Name:NEIGHBORMD OF NEWNAN LLC
Entity type:Organization
Organization Name:NEIGHBORMD OF NEWNAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-459-3661
Mailing Address - Street 1:770 GREISON TRL
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-6408
Mailing Address - Country:US
Mailing Address - Phone:770-251-4120
Mailing Address - Fax:770-251-4575
Practice Address - Street 1:770 GREISON TRL
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-6408
Practice Address - Country:US
Practice Address - Phone:770-251-4120
Practice Address - Fax:770-251-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty