Provider Demographics
NPI:1588713804
Name:MIDWEST NEUROLOGY, PC
Entity type:Organization
Organization Name:MIDWEST NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUKHSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-552-9500
Mailing Address - Street 1:820 BYRON RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1098
Mailing Address - Country:US
Mailing Address - Phone:517-552-9500
Mailing Address - Fax:517-552-9555
Practice Address - Street 1:820 BYRON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1098
Practice Address - Country:US
Practice Address - Phone:517-552-9500
Practice Address - Fax:517-552-9555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH17505Medicare UPIN