Provider Demographics
NPI:1033386545
Name:FLINT NEUROSCIENCE CENTER, PLLC
Entity Type:Organization
Organization Name:FLINT NEUROSCIENCE CENTER, PLLC
Other - Org Name:NEUROLOGY DIVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BHRANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-2491
Mailing Address - Street 1:DEPT. CH 17809
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-7809
Mailing Address - Country:US
Mailing Address - Phone:810-230-2491
Mailing Address - Fax:810-732-4344
Practice Address - Street 1:G3239 BEECHER RD
Practice Address - Street 2:SUITE C
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3616
Practice Address - Country:US
Practice Address - Phone:810-230-2491
Practice Address - Fax:810-732-4344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLINT NEUROSCIENCE CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C16427OtherMEDICARE RAILROAD
700B511200OtherBCBS OF MICHIGAN
0M90390Medicare PIN