UNIVERISTY AFFILIATED NEUROLOGISTS (NPI# 1952330474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952330474 |
| Entity Type | Organization |
| Organization Name | UNIVERISTY AFFILIATED NEUROLOGISTS |
| Practice Address |
4201 St. Antoine St Suite 8d Detroit MI 48201 |
| Mailing Address |
3800 Woodward Ave. Suite 702 Detroit MI 48201 |
| Practice Telephone | 3137454275 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT LISAK (DEPARTMENT CHAIR) |
| Authorized Official Telephone | 3135771249 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| X | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| X | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4201 ST. ANTOINE ST SUITE 8D |
| City | DETROIT |
| State | MI |
| Zip Code | 48201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215558317 | Sarah Nicole Noveroske Philbrick | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Rm 6g-uhc, Detroit, MI 48201 | 2020-04-29 |
| 1053931493 | Ishan Patel | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Uhc-9c, Detroit, MI 48201 | 2020-04-24 |
| 1740800457 | Anuj Khetarpal | Anesthesiology | 4201 St. Antoine St, 9c-uhc, Detroit, MI 48201 | 2020-04-22 |
| 1851958870 | Ameena Syed | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, 9c-uhc, Detroit, MI 48201 | 2019-05-24 |
| 1255994562 | Abdul Kareem Zalikha | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Uhc 9-b, Dept of Orthopaedic Surgery, Detroit, MI 48201-2153 | 2019-04-22 |
| 1073002986 | Omar Chehab | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Suite 2e, Detroit, MI 48201 | 2018-05-07 |
| 1629566054 | Sohaip Mohammad Shafeeq Kabashneh | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Detroit, MI 48201 | 2018-05-01 |
| 1114415460 | Bismark Kodji | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Detroit, MI 48201-2153 | 2018-04-23 |
| 1013366699 | Nadia Nasser | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, 9c-uhc, Detroit, MI 48201 | 2016-06-06 |
| 1487009551 | Ajit Singh Thakur | Internal Medicine | 4201 St. Antoine St, Detroit Education and Research, Graduate Medical Educat, Detroit, MI 48201 | 2016-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588828453 | Jin Lee Kim | Clinical Neuropsychologist | 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 | 2008-07-10 |
| 1841340312 | Raymond Mckinley Campbell IIi | Clinical Neuropsychologist | 1511 1st St, Suite 1308, Detroit, MI 48226-1351 | 2007-01-10 |
| 1104939107 | Jannel M Phillips | Clinical Neuropsychologist | 1 Ford Place, Detroit, MI 48202 | 2006-08-16 |
| 1457390254 | University Physician Group | Clinical Neuropsychologist | 4201 Saint Antoine St., Suite 8d, Detroit, MI 48201 | 2006-06-06 |
| 1225038904 | Scott Richard Millis | Clinical Neuropsychologist | 261 Mack Ave, Rehabilitation Institute of Michigan, Rm 552, Detroit, MI 48201-2417 | 2005-07-26 |
| 1285116384 | Allison Josephine Lake | Clinical Neuropsychologist | 261 Mack Ave Ste 555, Detroit, MI 48201-2417 | 2018-09-05 |
| 1487193207 | Vilija Petrauskas | Clinical Neuropsychologist | 1 Ford Pl Ste 1e, Detroit, MI 48202-3450 | 2017-02-13 |
| 1053659482 | Brent Funk | Clinical Neuropsychologist | 1 Ford Pl, 1e, Detroit, MI 48202-3450 | 2013-01-18 |
| 1215295191 | Kathleen Margaret Hagelthorn | Clinical Neuropsychologist | 1 Ford Pl Ste 2e, Detroit, MI 48202-3450 | 2012-04-27 |
| 1063741270 | Adult Neuropsychology | Clinical Neuropsychologist | 4201 Saint Antoine St, 4j Uhc, Detroit, MI 48201-2153 | 2009-12-17 |
| Find all providers in DETROIT | ||||
Please comment or provide details below to improve the information on UNIVERISTY AFFILIATED NEUROLOGISTS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.