Provider Demographics
NPI:1649469248
Name:PSYCHIATRY ASSOCIATES, PC
Entity type:Organization
Organization Name:PSYCHIATRY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANCUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-765-5436
Mailing Address - Street 1:251 E MERRILL ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 E MERRILL ST
Practice Address - Street 2:SUITE 230
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6121
Practice Address - Country:US
Practice Address - Phone:248-765-5436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010745252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P17490Medicare PIN