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Individual
DR. NEILLY ANN BUCKALEW
Active
Individual
DR. NEILLY ANN BUCKALEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
105626
MN
208100000X
Physical Medicine & Rehabilitation Physician
Primary
15303
ND
208100000X
Physical Medicine & Rehabilitation Physician
54367
MN
208100000X
Physical Medicine & Rehabilitation Physician
MD455877
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT197074
PA
Other
Enumeration date
04/30/2010
Last updated
10/17/2023
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