Downriver Neurology PC
Organization Active NPI Neurology Physician · Riverview, MI
NPI 1275728107 · NPPES record last updated Apr 4, 2011
Key facts
- NPI
- 1275728107
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 4301078496 (MI)
- Legal business name
- DOWNRIVER NEUROLOGY PC
- Practice address
- 17515 Fort St
Riverview, MI 48193-6630 - Phone
- (734) 225-7770
- NPI assigned
- Sep 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher James Whitty, M.D., PH.D.
- Title
- President
- Phone
- (734) 225-7770
Practitioners 1
-
Christopher James Whitty, M.D., PH.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050811000473 | MI | Part B Supplier - Clinic/Group Practice | 3476582214 |
Receives reassigned benefits from 1 practitioner Practice locations: Riverview, MI |
National Provider Directory
Locations
17515 Fort St
Riverview, MI 48193
Phone (734) 225-7770
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDFHBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | 4301078496 | MI | Yes |
Addresses
Primary practice location
17515 Fort St
Riverview, MI 48193-6630
Mailing address
17515 Fort St
Riverview, MI 48193-6630
Phone (734) 225-7770
Other providers in Riverview, MI
- Downriver Family Health PLLC
- Downriver Internal Medicine PC
- Downriver Internal Medicine, PC
- Downriver Medical LLC
- Downriver Medical Suppies Inc
- Downriver Speech Clinic LLC
- Jeannie F Drinkert
- Michael Walter Dudick
- Donald John Duford
- Karen Dunnigan
All providers in Riverview, MI · Neurology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.