| Novi Neurology Pc | |
|
44000 W 12 Mile Rd Ste 213 Novi MI 48377-2644 | |
| (248) 347-8293 | |
| (248) 305-6847 |
| Full Name | Novi Neurology Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 44000 W 12 Mile Rd, Novi, Michigan |
| Authorized Official Name and Position | Vijay Samuel (PRESIDENT) |
| Authorized Official Contact | 2483478293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Novi Neurology Pc Po Box 1038 Bloomfield MI 48303-1038 Ph: (248) 347-8293 | Novi Neurology Pc 44000 W 12 Mile Rd Ste 213 Novi MI 48377-2644 Ph: (248) 347-8293 |
| NPI Number | 1962704585 |
|---|---|
| Provider Enumeration Date | 12/02/2010 |
| Last Update Date | 12/02/2010 |
| Medicare PECOS PAC ID | 4587851811 |
|---|---|
| Medicare Enrollment ID | O20101213000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962704585 | NPI | - | NPPES |
| 4477679 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301060170 (Michigan) | Primary |
| Provider Name | Vijay Samuel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285787739 PECOS PAC ID: 2567559354 Enrollment ID: I20071025000435 |
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