University Affiliated Neurologists, Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

UNIVERSITY AFFILIATED NEUROLOGISTS, INC

Practice address

4201 Saint Antoine St
Suite 8D
Detroit, MI 48201-2153

Phone

(313) 745-4275

NPI assigned

May 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzanne Wasmundt

Title

Director

Phone

(313) 577-8958

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Univ Affiliated Neurologists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Univeristy Affiliated Neurologists

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1952330474
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124249420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 8D",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY AFFILIATED NEUROLOGISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASMUNDT",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-577-8958"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "0H24771",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Universal Wellness Institute
• University Dermatology
• University Eye Associates
• University Eye Physicians
• University Family Physicians
• University Internal Medicine Specialists

• Clinical Neuropsychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.