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Individual
S. GLEN NEALE
Active
Individual
S. GLEN NEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0420008384
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00018233
BLUE CROSS
VT
05
—
OVN0158
—
VT
Enumeration date
07/26/2006
Last updated
07/08/2007
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