Basic Information
| Provider Information | |||||||||
| NPI: | 1720021421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEFF | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | SHAWN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 JARRETT WHITE RD | ||||||||
| Address2: | TRIPLER AMC ATTN:MCHK-QS | ||||||||
| City: | TRIPLER AMC | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968595001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084332460 | ||||||||
| FaxNumber: | 8084331558 | ||||||||
| Practice Location | |||||||||
| Address1: | 4076 NEELY RD | ||||||||
| Address2: | BASSET ARMY COMMUNITY HOSPITAL | ||||||||
| City: | FORT WAINWRIGHT | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073615322 | ||||||||
| FaxNumber: | 9073614386 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 12/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DOS-1097 | HI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.