| Wayne Neuroscience Management, Llc | |
|
34815 W Michigan Ave Ste 4 Wayne MI 48184-1992 | |
| (734) 578-3643 | |
| (734) 725-3184 |
| Full Name | Wayne Neuroscience Management, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 34815 W Michigan Ave Ste 4, Wayne, Michigan |
| Authorized Official Name and Position | Shaheen Younus (ADMINISTRATOR) |
| Authorized Official Contact | 7345783643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Neuroscience Management, Llc 34815 W Michigan Ave Ste 4 Wayne MI 48184-1992 Ph: (734) 578-3643 | Wayne Neuroscience Management, Llc 34815 W Michigan Ave Ste 4 Wayne MI 48184-1992 Ph: (734) 578-3643 |
| NPI Number | 1013594290 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 03/25/2021 |
| Certification Date | 03/23/2021 |
| Medicare PECOS PAC ID | 4385052463 |
|---|---|
| Medicare Enrollment ID | O20210412000422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013594290 | NPI | - | NPPES |
| 130H229360 | Other | MI | BLUE CROSS BLUE SHEILD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Nilofer Nisar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922094564 PECOS PAC ID: 4981682143 Enrollment ID: I20040713000814 |
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