Comprehensive Clinical Neurology P.c. | |
28075 Ranchwood Dr Southfield MI 48076-2401 | |
(248) 559-8737 | |
(248) 559-7283 |
Full Name | Comprehensive Clinical Neurology P.c. |
---|---|
Speciality | Psychiatry & Neurology |
Location | 28075 Ranchwood Dr, Southfield, Michigan |
Authorized Official Name and Position | David Gaston (DR) |
Authorized Official Contact | 2485598737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Comprehensive Clinical Neurology P.c. 28075 Ranchwood Dr Southfield MI 48076-2401 Ph: (248) 559-8737 | Comprehensive Clinical Neurology P.c. 28075 Ranchwood Dr Southfield MI 48076-2401 Ph: (248) 559-8737 |
NPI Number | 1891936977 |
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Provider Enumeration Date | 03/18/2009 |
Last Update Date | 05/11/2023 |
Certification Date | 05/10/2023 |
Medicare PECOS PAC ID | 3274675004 |
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Medicare Enrollment ID | O20100116000271 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891936977 | NPI | - | NPPES |
DP8335 | Other | MI | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | DG050339 (Michigan) | Primary |
261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
Provider Name | David L Gaston |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1811000227 PECOS PAC ID: 0749322576 Enrollment ID: I20100116000251 |
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