Mi Neurosurgery Clinic PC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004125 Issued in MI

Legal business name

MI NEUROSURGERY CLINIC PC

Practice address

3635 Genesys Pkwy
Grand Blanc, MI 48439-8070

Phone

(810) 606-7535

Fax

(810) 606-7510

NPI assigned

Feb 13, 2007

Last updated

Sep 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn Tartaglione, DONPI 1588693865

Title

Owner

Phone

(810) 424-2007

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Dawn R Tartaglione, D.O.

  • Neurological Surgery Physician
  • Dover, DE
  • NPI 1588693865
  NPD (past) Authorized official
• Rebecca R Wellington, PA-C

  • Physician Assistant
  • Moore, OK
  • NPI 1942218755
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1912049099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2007",
            "fax_number": "810-743-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398070",
            "telephone_number": "810-606-7535",
            "fax_number": "810-606-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI NEUROSURGERY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "TARTAGLIONE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-424-2007",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Ellen Metteer, DO
• Bradley Metz, CRNA
• Daniel Meyer, DMD
• Mi Neurosurgery Clinic PC
• Mi Neurosurgery Clinic PC
• Michael J. Sorscher M.D., P.C.
• Michael Wolfgram DDS PC (Lakeside Dental Associates)
• Michael J Michael Jr., M.D.
• Andrew Mena Michail, DO
• Michigan Dental Wellness Center PLLC

• Physician Assistant in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.