Provider Demographics
NPI:1952693871
Name:UNIVERSITY OF MICHIGAN
Entity Type:Organization
Organization Name:UNIVERSITY OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECTION DIRECTOR, NEUROPSYCHOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUNO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORDANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-763-9259
Mailing Address - Street 1:2101 COMMONWEALTH BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2969
Mailing Address - Country:US
Mailing Address - Phone:734-763-9259
Mailing Address - Fax:734-936-9262
Practice Address - Street 1:2101 COMMONWEALTH BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2969
Practice Address - Country:US
Practice Address - Phone:734-763-9259
Practice Address - Fax:734-936-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014318273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit