Individual
DR. MARY LU MCNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3605 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4666
(678) 804-7430
(678) 804-7418
Mailing address
3605 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4666
(678) 804-7430
(678) 804-7418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38869
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063551950
UPIN C19231
GA
Enumeration date
02/06/2007
Last updated
05/16/2013
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