Michigan Neuro Diagnostics PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

49561020 Issued in WI

Legal business name

MICHIGAN NEURO DIAGNOSTICS PC

Practice address

42621 Garfield
Ste 110
Clinton Township, MI 48038

Phone

(586) 228-9065

Fax

(586) 228-9039

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Barbara Garrett Nelson, MD

Title

President

Phone

(586) 228-9065

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1508949140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380168",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480380061",
            "telephone_number": "586-228-9065",
            "fax_number": "586-228-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42621 GARFIELD",
            "address_2": "STE 110",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-228-9065",
            "fax_number": "586-228-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN NEURO DIAGNOSTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-228-9065",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "BN041753",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "49561020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "1304700052",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Vredevoogd PC
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• Michigan Hospital Physicians, PC
• Michigan MSK Medicine PLLC
• Michigan Neurology Associates
• Michigan Physical Medicine and Rehabilitation, P.C.
• Michigan Physical Therapy
• Michigan Rehab Consultant PC
• Michigan Surgical Group

• Surgery Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.