Organization
MIDMICHIGAN NEUROPSYCHOLOGY ASSOCIATES, P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM D MACINNES PH.D. (MEMBER)
(989) 921-5100
Entity
Organization
Contact information
Practice address
4705 TOWNE CENTRE RD., SUITE 304, SAGINAW, MI 48604-2821
(989) 921-5100
(989) 921-5104
Mailing address
4705 TOWNE CENTRE RD., SUITE 304, SAGINAW, MI 48604-2821
(989) 921-5100
(989) 921-5104
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301008040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P93585
BLUE CARE NETWORK
MI
01
—
WM008040
BCBS
MI
Enumeration date
02/04/2010
Last updated
11/22/2017
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