Individual
CHARLES A MACNEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5730 GLENRIDGE DR NE, SUITE 100, SANDY SPRINGS, GA 30328-6141
(404) 816-3000
(678) 904-5797
Mailing address
790 CHURCH ST NE, SUITE 550, MARIETTA, GA 30060-7282
(770) 419-9902
(770) 419-7457
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
021543
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
021543
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1647492
CIGNA
GA
01
—
1710946322
GROUP NPI NUMBER
GA
Enumeration date
04/14/2006
Last updated
01/12/2011
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