Provider Demographics
NPI:1356668610
Name:MICHIGAN INSTITUTE OF NEUROLOGICAL DISEASES, PLLC
Entity Type:Organization
Organization Name:MICHIGAN INSTITUTE OF NEUROLOGICAL DISEASES, PLLC
Other - Org Name:MICHIGAN MIND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:UMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-990-5331
Mailing Address - Street 1:5091 OAK TREE CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-8573
Mailing Address - Country:US
Mailing Address - Phone:517-795-1416
Mailing Address - Fax:517-787-4280
Practice Address - Street 1:205 PAGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2462
Practice Address - Country:US
Practice Address - Phone:517-795-1416
Practice Address - Fax:517-787-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010723782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty