Basic Information
Provider Information
NPI: 1194168559
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NEELAND
FirstName: MARC
MiddleName: ADAM
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 35 COLLIER RD NW
Address2: SUITE 635
City: ATLANTA
State: GA
PostalCode: 303091613
CountryCode: US
TelephoneNumber: 4043673014
FaxNumber: 4045039280
Practice Location
Address1: 35 COLLIER RD NW
Address2: SUITE 635
City: ATLANTA
State: GA
PostalCode: 303091613
CountryCode: US
TelephoneNumber: 4043673014
FaxNumber: 4045039280
Other Information
ProviderEnumerationDate: 04/16/2013
LastUpdateDate: 03/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X75334GAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X075334GAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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