Provider Demographics
NPI:1669752523
Name:LAPEER NEUROLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:LAPEER NEUROLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-667-9132
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-0190
Mailing Address - Country:US
Mailing Address - Phone:810-667-9132
Mailing Address - Fax:810-667-0026
Practice Address - Street 1:237 DAVIS LAKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1485
Practice Address - Country:US
Practice Address - Phone:810-667-9132
Practice Address - Fax:810-667-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010478562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP28750001Medicare PIN