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General NPI Number Information
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NPI Number | 1457794513
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Entity Type | Organization
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Legal Business Name | MICHIGAN CLINIC NEUROSURGERY PLLC
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 3160 CABARET TRL S
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City | SAGINAW
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State | MI
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Zip | 48603-2202
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Country | US
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Telephone | 989-799-8712
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Fax | 989-799-0222
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Provider Business Mailing Address
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Address Line | 3160 CABARET TRL S
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City | SAGINAW
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State | MI
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Zip | 48603-2202
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Country | US
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Telephone | 989-799-8712
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Fax | 989-799-0222
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | GERALD R SCHELL
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Credential | MD
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Telephone | 989-799-8712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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