Active NPI
Wayne Neuroscience Management, LLC
- Neurology Physician
- Wayne, MI
National Provider Identifier
1013594290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- Legal business name
- WAYNE NEUROSCIENCE MANAGEMENT, LLC
- Practice address
- 34815 W Michigan Ave Ste 4
Wayne, MI 48184-1992 - Phone
- (734) 578-3643
- Fax
- (734) 725-3184
- NPI assigned
- Mar 25, 2021
- Organization subpart
- Yes
- Parent organization
- WAYNE NEUROSCIENCE MANAGEMENT, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shaheen Younus
- Title
- Administrator
- Phone
- (734) 578-3643
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | Primary |
Addresses
Primary practice location
34815 W Michigan Ave Ste 4
Wayne, MI 48184-1992
Mailing address
34815 W Michigan Ave Ste 4
Wayne, MI 48184-1992
Phone (734) 578-3643
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130H229360 | Other | MI | BLUE CROSS BLUE SHEILD |
National Provider Directory
National Provider Directory- Part of
- Wayne Neuroscience Management LLC
Locations
34815 W Michigan Ave
Ste 4
Wayne, MI 48184
Phone (734) 578-3643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616630400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616630400000",
"number": "1013594290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34815 W MICHIGAN AVE STE 4",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841992",
"telephone_number": "734-578-3643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34815 W MICHIGAN AVE STE 4",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841992",
"telephone_number": "734-578-3643",
"fax_number": "734-725-3184"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAYNE NEUROSCIENCE MANAGEMENT, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WAYNE NEUROSCIENCE MANAGEMENT, LLC",
"enumeration_date": "2021-03-25",
"last_updated": "2021-03-25",
"certification_date": "2021-03-23",
"status": "A",
"authorized_official_last_name": "YOUNUS",
"authorized_official_first_name": "SHAHEEN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "734-578-3643"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "130H229360",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.