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General NPI Number Information
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NPI Number | 1952693871
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MICHIGAN
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 2101 COMMONWEALTH BLVD SUITE C
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City | ANN ARBOR
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State | MI
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Zip | 48105-2969
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Country | US
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Telephone | 734-763-9259
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Fax | 734-936-9262
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Provider Business Mailing Address
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Address Line | 2101 COMMONWEALTH BLVD SUITE C
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City | ANN ARBOR
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State | MI
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Zip | 48105-2969
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Country | US
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Telephone | 734-763-9259
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Fax | 734-936-9262
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Authorized Official
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Title or Position | SECTION DIRECTOR, NEUROPSYCHOLOGY
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Name | DR. BRUNO GIORDANI
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Credential | PH.D.
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Telephone | 734-763-9259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 6301014318
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License Number State | MI
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