| Michigan Institute Of Neurology And Epilepsy Pc | |
|
44555 Woodward Ave Ste 104 Pontiac MI 48341-5032 | |
| (248) 858-6104 | |
| (248) 858-6115 |
| Full Name | Michigan Institute Of Neurology And Epilepsy Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 44555 Woodward Ave Ste 104, Pontiac, Michigan |
| Authorized Official Name and Position | Basel Assaad (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2488855650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Institute Of Neurology And Epilepsy Pc 5635 Old Carriage Ln West Bloomfield MI 48322-1653 Ph: (248) 885-5650 | Michigan Institute Of Neurology And Epilepsy Pc 44555 Woodward Ave Ste 104 Pontiac MI 48341-5032 Ph: (248) 858-6104 |
| NPI Number | 1023539962 |
|---|---|
| Provider Enumeration Date | 06/30/2017 |
| Last Update Date | 06/30/2017 |
| Medicare PECOS PAC ID | 6709158215 |
|---|---|
| Medicare Enrollment ID | O20170817003913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023539962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Basel Assaad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154531937 PECOS PAC ID: 8729104112 Enrollment ID: I20100922000942 |
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