Organization
WAYNE NEUROSCIENCE MANAGEMENT, LLC
Active
Parent organization
WAYNE NEUROSCIENCE MANAGEMENT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAYNE NEUROSCIENCE MANAGEMENT, LLC
Authorized official
SHAHEEN YOUNUS (ADMINISTRATOR)
(734) 578-3643
Entity
Organization
Contact information
Practice address
34815 W MICHIGAN AVE STE 4, WAYNE, MI 48184-1992
(734) 578-3643
(734) 725-3184
Mailing address
34815 W MICHIGAN AVE STE 4, WAYNE, MI 48184-1992
(734) 578-3643
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130H229360
BLUE CROSS BLUE SHEILD
MI
Enumeration date
03/25/2021
Last updated
03/25/2021
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