| Brainspan | |
|
5301 Mcauley Dr Ypsilanti MI 48197-1051 | |
| (734) 712-3456 | |
| Not Available |
| Full Name | Brainspan |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5301 Mcauley Dr, Ypsilanti, Michigan |
| Authorized Official Name and Position | Julie Shawver (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 4194690636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainspan 2415 Underhill Rd Ottawa Hills OH 43615-2331 Ph: () - | Brainspan 5301 Mcauley Dr Ypsilanti MI 48197-1051 Ph: (734) 712-3456 |
| NPI Number | 1811663578 |
|---|---|
| Provider Enumeration Date | 08/20/2021 |
| Last Update Date | 08/20/2021 |
| Certification Date | 08/20/2021 |
| Medicare PECOS PAC ID | 4183015233 |
|---|---|
| Medicare Enrollment ID | O20211227001159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811663578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | (* (Not Available)) | Primary |
| Provider Name | Mouhammad Aghiad Jumaa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124287164 PECOS PAC ID: 9234280041 Enrollment ID: I20180719002162 |
| Provider Name | Syed Zaidi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619177748 PECOS PAC ID: 5698848273 Enrollment ID: I20200407000826 |
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