| Neurology & Sleep Medicine Assoc | |
|
2919 S Ellsworth Rd Suite 135 Mesa AZ 85212-2144 | |
| (480) 967-6888 | |
| (480) 967-6887 |
| Full Name | Neurology & Sleep Medicine Assoc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2919 S Ellsworth Rd, Mesa, Arizona |
| Authorized Official Name and Position | George Wang (PRESIDENT) |
| Authorized Official Contact | 4809676888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology & Sleep Medicine Assoc 2919 S Ellsworth Rd,suite135 Suite 135 Mesa AZ 85212 Ph: (480) 967-6888 | Neurology & Sleep Medicine Assoc 2919 S Ellsworth Rd Suite 135 Mesa AZ 85212-2144 Ph: (480) 967-6888 |
| NPI Number | 1184679201 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 01/15/2008 |
| Medicare PECOS PAC ID | 6608789755 |
|---|---|
| Medicare Enrollment ID | O20031106000242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184679201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 261QS1200X | Clinic/center - Sleep Disorder Diagnostic | (* (Not Available)) | Secondary |
| Provider Name | George Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851342828 PECOS PAC ID: 2264345164 Enrollment ID: I20031125000804 |
| Provider Name | Kandra K Flora |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184787996 PECOS PAC ID: 8527164979 Enrollment ID: I20070611000289 |
| Provider Name | Gary T Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881675874 PECOS PAC ID: 9537144746 Enrollment ID: I20100720001081 |
| Provider Name | Erik W Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033129150 PECOS PAC ID: 0042450678 Enrollment ID: I20130717000168 |
| Provider Name | Hemadevi Chenthilmurugan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1497058648 PECOS PAC ID: 3173749199 Enrollment ID: I20150806011476 |
| Provider Name | Shuang Linn Krus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285019596 PECOS PAC ID: 5294041356 Enrollment ID: I20150903001643 |
| Provider Name | John Samaan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225325988 PECOS PAC ID: 9133413164 Enrollment ID: I20190821000946 |
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