Healthcare Provider Details

I. General information

NPI: 1588713804
Provider Name (Legal Business Name): MIDWEST NEUROLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 BYRON RD SUITE 400
HOWELL MI
48843-1098
US

IV. Provider business mailing address

820 BYRON RD SUITE 400
HOWELL MI
48843-1098
US

V. Phone/Fax

Practice location:
  • Phone: 517-552-9500
  • Fax: 517-552-9555
Mailing address:
  • Phone: 517-552-9500
  • Fax: 517-552-9555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. RUKHSANA BEGUM
Title or Position: PRESIDENT
Credential: MD
Phone: 517-552-9500