Provider Demographics
NPI:1679785968
Name:MCNEIL, MICHAEL GARY (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GARY
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:90 MATAWAN RD
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2623
Mailing Address - Country:US
Mailing Address - Phone:732-353-7233
Mailing Address - Fax:732-353-7507
Practice Address - Street 1:90 MATAWAN RD
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2623
Practice Address - Country:US
Practice Address - Phone:732-353-7233
Practice Address - Fax:732-353-7507
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04991800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine