NPIMap

Organization Active NPI

Neurology Michigan PC

  • Neurology Physician
  • Wyandotte, MI
National Provider Identifier
1336406552
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301034377 Issued in MI
Legal business name
NEUROLOGY MICHIGAN PC
Practice address
1848 Biddle Ave
Suite 101
Wyandotte, MI 48192-3962
Phone
(734) 284-2600
Fax
(734) 284-2666
NPI assigned
Apr 12, 2012
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Girish Chand Mangalick, MDNPI 1225039522
Title
Owner/Med Director
Phone
(734) 284-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X 4301034377 MI Primary

Addresses

Primary practice location

1848 Biddle Ave
Suite 101
Wyandotte, MI 48192-3962

Mailing address

1848 Biddle Ave
Suite 101
Wyandotte, MI 48192-3962
Phone (734) 284-2600

National Provider Directory

National Provider Directory

Locations

1848 Biddle Ave
Ste 101
Wyandotte, MI 48192
Phone (734) 284-2600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1336406552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 BIDDLE AVE",
            "address_2": "SUITE 101",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923962",
            "telephone_number": "734-284-2600",
            "fax_number": "734-284-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 BIDDLE AVE",
            "address_2": "SUITE 101",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923962",
            "telephone_number": "734-284-2600",
            "fax_number": "734-284-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "MANGALICK",
        "authorized_official_first_name": "GIRISH",
        "authorized_official_middle_name": "CHAND",
        "authorized_official_title_or_position": "OWNER/MED DIRECTOR",
        "authorized_official_telephone_number": "734-284-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301034377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.