Provider Demographics
NPI:1811450844
Name:UMLES, NEIL SAMUEL (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:SAMUEL
Last Name:UMLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45640 SCHOENHERR RD STE B
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-6033
Mailing Address - Country:US
Mailing Address - Phone:586-247-4300
Mailing Address - Fax:586-532-6496
Practice Address - Street 1:22201 MOROSS RD STE 50
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2166
Practice Address - Country:US
Practice Address - Phone:313-343-7774
Practice Address - Fax:313-343-8747
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301510950207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program