Provider Demographics
NPI:1457794513
Name:MICHIGAN CLINIC NEUROSURGERY PLLC
Entity Type:Organization
Organization Name:MICHIGAN CLINIC NEUROSURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-799-8712
Mailing Address - Street 1:3160 CABARET TRL S
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2202
Mailing Address - Country:US
Mailing Address - Phone:989-799-8712
Mailing Address - Fax:989-799-0222
Practice Address - Street 1:3160 CABARET TRL S
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2202
Practice Address - Country:US
Practice Address - Phone:989-799-8712
Practice Address - Fax:989-799-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty