Provider Demographics
NPI:1174798599
Name:NEAL, ANNA CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CATHERINE
Last Name:NEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL RIDGE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4267
Practice Address - Country:US
Practice Address - Phone:864-220-7270
Practice Address - Fax:864-241-9211
Is Sole Proprietor?:No
Enumeration Date:2008-04-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-00086208000000X
ARE-6841208000000X
SC38136208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1174798599Medicaid
SC381367Medicaid
NC5920785Medicaid
NCNC7089NMedicare PIN
NCNC7089LMedicare PIN
NCNC7089CMedicare PIN
NCNC7089EMedicare PIN
SCSC6174Medicare PIN
NCNC7089AMedicare PIN
NCNC7089DMedicare PIN
NCNC7089KMedicare PIN
NCNC7089MMedicare PIN
NCNC7089BMedicare PIN
NCNC7089OMedicare PIN
NCNC7089HMedicare PIN
SC381367Medicaid
NCNC7089FMedicare PIN
NC5920785Medicaid
NCNC7089GMedicare PIN