Provider Demographics
NPI:1285664979
Name:CENTER FOR NEUROLOGICAL SURGERY PC
Entity Type:Organization
Organization Name:CENTER FOR NEUROLOGICAL SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-348-5622
Mailing Address - Street 1:515 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2223
Mailing Address - Country:US
Mailing Address - Phone:231-348-5622
Mailing Address - Fax:231-348-5625
Practice Address - Street 1:515 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2223
Practice Address - Country:US
Practice Address - Phone:231-348-5622
Practice Address - Fax:231-348-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M17480Medicare ID - Type Unspecified
6001400001Medicare NSC