Healthcare Provider Details

I. General information

NPI: 1598802076
Provider Name (Legal Business Name): BG TRICOUNTY NEUROLOGY& SLEEP CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 05/05/2020
Certification Date: 05/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31150 HOOVER RD SUITE B
WARREN MI
48093-7618
US

IV. Provider business mailing address

PO BOX 548
BIRMINGHAM MI
48012-0548
US

V. Phone/Fax

Practice location:
  • Phone: 586-983-3666
  • Fax: 248-652-7906
Mailing address:
  • Phone: 248-652-7520
  • Fax: 248-652-7906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: NARAYAN P VERMA
Title or Position: PRESIDENT
Credential: MD
Phone: 586-983-8011