| Greenville Neuro Diagnostic Center, P.c. | |
|
1502 S Colorado St Greenville MS 38703-7219 | |
| (662) 332-9872 | |
| (662) 332-9878 |
| Full Name | Greenville Neuro Diagnostic Center, P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1502 S Colorado St, Greenville, Mississippi |
| Authorized Official Name and Position | Mohammed A Ahmed (PRESIDENT) |
| Authorized Official Contact | 6623329872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenville Neuro Diagnostic Center, P.c. 1502 S Colorado St Greenville MS 38703-7219 Ph: (662) 332-9872 | Greenville Neuro Diagnostic Center, P.c. 1502 S Colorado St Greenville MS 38703-7219 Ph: (662) 332-9872 |
| NPI Number | 1457798241 |
|---|---|
| Provider Enumeration Date | 06/03/2013 |
| Last Update Date | 06/03/2013 |
| Medicare PECOS PAC ID | 7517100035 |
|---|---|
| Medicare Enrollment ID | O20130903000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457798241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 16065 (Mississippi) | Primary |
| Provider Name | Mohammad A Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861458762 PECOS PAC ID: 7517032287 Enrollment ID: I20080814000162 |
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