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BLOOMFIELD NEUROLOGY CLINIC P.C. NPI 1134202732


NPI Information

NPI: 1134202732
Provider Name: BLOOMFIELD NEUROLOGY CLINIC, P.C.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
43494 WOODWARD AVE
SUITE 103
BLOOMFIELD HILLS, MI
ZIP 48302
Phone: (248) 338-8400
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BLOOMFIELD NEUROLOGY CLINIC, P.C. is a neurology psychiatry neurology in Bloomfield Hills, MI. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. BLOOMFIELD NEUROLOGY CLINIC, P.C. NPI is 1134202732. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

43494 WOODWARD AVE
SUITE 103
BLOOMFIELD HILLS, MI
ZIP 48302-052
Phone: (248) 338-8400
Fax: (248) 338-8151

The provider's authorized official is Lionel Glass .
The authorized official title is President and has the following contact phone number (248) 338-8400.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 4/15/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurology4301031094MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13504593MEDICAIDMICHIGAN
2B48345MEDICARE UPINMICHIGAN
30P47550MEDICARE PINMICHIGAN
4130635749OTHERMICHIGANBCBS
50M59060MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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