Glendale Neurological Associates P C
NPI 1639134414ActiveOrganization· Psychiatry & Neurology, Neurology· Farmington Hills, MI
Psychiatry & Neurology, Neurology in Farmington Hills, Michigan, registered in NPPES in April 2006. The authorized official on file is William D. Boudouris, DO, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1639134414 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 18, 2006 |
| Last updated in NPPES | Sep 9, 2026 |
| Certified by provider | Sep 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Neurology Primary | 2084N0400X | — | MI |
| Pain Medicine, Interventional Pain Medicine | 208VP0014X | — | — |
| Clinic/Center, Radiology | 261QR0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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