Provider Demographics
NPI:1083703516
Name:GREATER ANN ARBOR NEUROLOGY ASSOCIATES P.C.
Entity Type:Organization
Organization Name:GREATER ANN ARBOR NEUROLOGY ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HORVATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-229-9799
Mailing Address - Street 1:2300 GENOA BUSINESS PARK DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7367
Mailing Address - Country:US
Mailing Address - Phone:810-229-9799
Mailing Address - Fax:810-229-1713
Practice Address - Street 1:2300 GENOA BUSINESS PARK DR
Practice Address - Street 2:SUITE 190
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7367
Practice Address - Country:US
Practice Address - Phone:810-229-9799
Practice Address - Fax:810-229-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D76012Medicare PIN
MI0D76012Medicare ID - Type Unspecified
MI0H16144Medicare PIN