Individual
MYTIA S MCNEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16601 N 40TH ST STE 204, PHOENIX, AZ 85032-3356
(602) 996-4747
(602) 953-5466
Mailing address
16601 N 40TH ST STE 204, PHOENIX, AZ 85032-3356
(602) 996-4747
(602) 953-5466
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33478
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z2266
AZ HEALTHNET
AZ
05
—
915332
—
AZ
01
—
AZ0772090
AZ BCBS
AZ
Enumeration date
07/12/2006
Last updated
07/21/2022
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