MEDICARE: NEONATOLOGY & INPATIENT PEDIATRICS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	4301055639	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4301055639	OTHER	MI	STATE LICENCE NUMBER

General Provider Information

NPI Number	:	1205052636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEONATOLOGY & INPATIENT PEDIATRICS, INC

Provider Business Mailing Address
First Line	:	1964 WESTLAKE CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-1286
Country	:	US
Telephone Number	:	248-932-2116
Fax Number	:	248-680-9555

Provider Business Practice Location Address
First Line	:	1964 WESTLAKE CT
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-1286
Country	:	US
Telephone Number	:	248-932-2116
Fax Number	:	248-680-9555

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ATHI NARAYAN
Credential	:	M.D.
Telephone Number	:	248-932-2116

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	11/07/2007

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