Provider Demographics
NPI:1487796371
Name:CENTRAL MICHIGAN HEADACHE AND NEUROLOGY PC
Entity type:Organization
Organization Name:CENTRAL MICHIGAN HEADACHE AND NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WEIGUO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-779-5260
Mailing Address - Street 1:1234 E BROOMFIELD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4496
Mailing Address - Country:US
Mailing Address - Phone:989-779-5260
Mailing Address - Fax:989-779-5264
Practice Address - Street 1:1234 E BROOMFIELD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4496
Practice Address - Country:US
Practice Address - Phone:989-779-5260
Practice Address - Fax:989-779-5264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty