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Individual
STEPHEN MARK MCNEILL
Active
Individual
STEPHEN MARK MCNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200400149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11541767
CAQH
NC
01
—
142W1
BCBS NC
NC
01
—
200400149
NC MEDICAL BOARD LICENSE
NC
05
—
5903489
—
NC
01
—
P00345715
RR MEDICARE
NC
Enumeration date
02/14/2006
Last updated
09/08/2020
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