Basic Information
Provider Information
NPI: 1750470613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBERS
FirstName: JAMES
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1500 EAST MEDICAL CENTER DR
Address2: 1ST FLOOR UNIVERSITY HOSPITAL ROOM 1B300
City: ANN ARBOR
State: MI
PostalCode: 481095036
CountryCode: US
TelephoneNumber: 7349369035
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/11/2006
LastUpdateDate: 02/20/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X4301040889MIY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

ID Information
IDTypeStateIssuerDescription
131583705MI MEDICAID


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