Healthcare Provider Details

I. General information

NPI: 1497707939
Provider Name (Legal Business Name): ANASTASIOS ALEXIOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANASTASIOS ALEXIOU MD

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR STE 6109
YPSILANTI MI
48197
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR PO BOX 0446 LOBBY J
ANN ARBOR MI
48106
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-1400
  • Fax: 734-712-1670
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4201406735
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301406735
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: