Provider Demographics
NPI:1982634184
Name:MID MICHIGAN NEUROLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:MID MICHIGAN NEUROLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-394-9864
Mailing Address - Street 1:3937 PATIENT CARE WAY
Mailing Address - Street 2:STE 103
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911
Mailing Address - Country:US
Mailing Address - Phone:517-394-9864
Mailing Address - Fax:517-394-6400
Practice Address - Street 1:3937 PATIENT CARE WAY
Practice Address - Street 2:STE 103
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911
Practice Address - Country:US
Practice Address - Phone:517-394-9864
Practice Address - Fax:517-394-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINP0481522084N0400X
MIJK0323212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1249900Medicaid
MI1626873Medicaid
MI0500674OtherPHP
MI0500075OtherPHP
MI0500075OtherPHP
B45950Medicare UPIN
MI1249900Medicaid