Individual
RICHARD ERVIN NEILS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
888 THACKERAY TRL, OCONOMOWOC, WI 53066
(262) 567-0247
(262) 567-2573
Mailing address
888 THACKERAY TRL, OCONOMOWOC, WI 53066
(262) 567-0247
(262) 567-2573
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20066
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30284400
—
WI
Enumeration date
02/21/2006
Last updated
07/08/2007
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