| Spectrum Rehabilitation Centers Inc | |
|
26555 Evergreen Rd Ste 830 Southfield MI 48076-4206 | |
| (248) 350-3650 | |
| (248) 350-1216 |
| Full Name | Spectrum Rehabilitation Centers Inc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 26555 Evergreen Rd, Southfield, Michigan |
| Authorized Official Name and Position | Bradley G Sewick (OWNER) |
| Authorized Official Contact | 2483503650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Rehabilitation Centers Inc 26555 Evergreen Rd Ste 830 Southfield MI 48076-4206 Ph: (248) 350-3650 | Spectrum Rehabilitation Centers Inc 26555 Evergreen Rd Ste 830 Southfield MI 48076-4206 Ph: (248) 350-3650 |
| NPI Number | 1215928643 |
|---|---|
| Provider Enumeration Date | 11/03/2005 |
| Last Update Date | 05/24/2021 |
| Certification Date | 05/24/2021 |
| Medicare PECOS PAC ID | 2365849403 |
|---|---|
| Medicare Enrollment ID | O20210916001307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215928643 | NPI | - | NPPES |
| 1193960001 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 6301005256 (Michigan) | Primary |
| Provider Name | Bradley George Sewick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801935549 PECOS PAC ID: 9537566674 Enrollment ID: I20210916001425 |
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