| Mid-michigan Neurology Center, Pllc | |
|
4595 Jennifer Ln Mt Pleasant MI 48858-2064 | |
| (989) 772-0453 | |
| (989) 773-2538 |
| Full Name | Mid-michigan Neurology Center, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4595 Jennifer Ln, Mt Pleasant, Michigan |
| Authorized Official Name and Position | Kandi Linn Preston (BILLING SPECIALIST) |
| Authorized Official Contact | 9894630957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-michigan Neurology Center, Pllc 4595 Jennifer Ln Mt Pleasant MI 48858-2064 Ph: (989) 772-0453 | Mid-michigan Neurology Center, Pllc 4595 Jennifer Ln Mt Pleasant MI 48858-2064 Ph: (989) 772-0453 |
| NPI Number | 1053648220 |
|---|---|
| Provider Enumeration Date | 11/10/2009 |
| Last Update Date | 06/06/2019 |
| Medicare PECOS PAC ID | 0244374726 |
|---|---|
| Medicare Enrollment ID | O20100222000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053648220 | NPI | - | NPPES |
| 500C700210 | Other | MI | BCBSM |
| 130C700220 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Michigan) | Primary |
| 363A00000X | Physician Assistant | (Michigan) | Secondary |
| 363L00000X | Nurse Practitioner | (Michigan) | Secondary |
| Provider Name | Zubair A Shaikh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205867082 PECOS PAC ID: 2860464757 Enrollment ID: I20040811000322 |
| Provider Name | Kristen M Telfor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225227721 PECOS PAC ID: 2961583588 Enrollment ID: I20080121000210 |
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