| Michigan Neuroscience Clinic Pllc | |
|
11780 Telegraph Rd Ste 100 Taylor MI 48180-6862 | |
| (734) 374-1112 | |
| (734) 374-1119 |
| Full Name | Michigan Neuroscience Clinic Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11780 Telegraph Rd Ste 100, Taylor, Michigan |
| Authorized Official Name and Position | Omar Ahmad (OWNER) |
| Authorized Official Contact | 3132314460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Neuroscience Clinic Pllc Po Box 86 Taylor MI 48180-0086 Ph: (734) 374-1112 | Michigan Neuroscience Clinic Pllc 11780 Telegraph Rd Ste 100 Taylor MI 48180-6862 Ph: (734) 374-1112 |
| NPI Number | 1033548581 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 8820227945 |
|---|---|
| Medicare Enrollment ID | O20140212000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033548581 | NPI | - | NPPES |
| MI7264 | Other | MI | MEDICARE PTAN LOCALITY 99 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301092682 (Michigan) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301093212 (Michigan) | Secondary |
| Provider Name | Faisal I Ahmad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528284866 PECOS PAC ID: 4183721707 Enrollment ID: I20070516000248 |
| Provider Name | Nawaf Murshed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619102134 PECOS PAC ID: 6002065869 Enrollment ID: I20121011000351 |
| Provider Name | Omar Ahmad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568623643 PECOS PAC ID: 2567615123 Enrollment ID: I20130109000619 |
| Provider Name | Payam Sadry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558717611 PECOS PAC ID: 9234424060 Enrollment ID: I20210713000521 |
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