WILMA AGNELLO-DIMITRIJEVIC M.D.
NPI 1104865443
Psychiatry & Neurology - Neurology in Clinton Twp, MI

NPI Status: Active since June 05, 2006

Contact Information

15855 19 MILE RD
CLINTON TWP, MI
ZIP 48038
Phone: (586) 263-2300

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  • Individual
  • Female
  • Psychiatry & Neurology
  • Neurology

About WILMA AGNELLO-DIMITRIJEVIC

This page provides the complete NPI Profile along with additional information for Wilma Agnello-dimitrijevic, a provider established in Clinton Twp, Michigan with a medical specialization in Psychiatry & Neurology, focusing in neurology . The healthcare provider is registered in the NPI registry with number 1104865443 assigned on June 2006. The practitioner's primary taxonomy code is 2084N0400X with license number WA058316 (MI). The provider is registered as an individual and her NPI record was last updated 17 years ago.

NPI
1104865443
Provider Name
WILMA AGNELLO-DIMITRIJEVIC M.D.
Gender
Female
Entity Type
Individual
Location Address
15855 19 MILE RD CLINTON TWP, MI 48038
Location Phone
(586) 263-2300
Mailing Address
43421 GARFIELD RD STE1 CLINTON TWP, MI 48038
Mailing Phone
(586) 286-5500
Mailing Fax
Is Sole Proprietor?
No
Enumeration Date
06-05-2006
Last Update Date
08-01-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Neurology

Taxonomy Code
2084N0400X
Type
Allopathic & Osteopathic Physicians
License No.
WA058316
License State
MI
Taxonomy Description
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3290951MEDICAID (05)MI 
OM28930MEDICARE ID-TYPE UNSPECIFIED (04)MI 
0N31900022MEDICARE PIN (08)MI 
G35382MEDICARE UPIN (02)MI 
1104865443MEDICAID (05)MI 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1104865443
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21041661048
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 1 + 6 + 6 + 1 + 0 + 4 + 8 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1104865443 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1255322467MS. JUDITH MCKENNA RN, NP
Individual
Nurse Practitioner15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 295-5387
1487632923 DENISE DYAR NP
Individual
Nurse Practitioner (Family)15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 236-2601
1336127406DR. SCOTT SIPP M.D.
Individual
Emergency Medicine15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 236-2601
1902884034 KAREN SCHWARTZ NP
Individual
Nurse Practitioner15855 19 MILE RD EMERGENCY MEDICINE DEPARTMENT
CLINTON TWP, MI 48038
(586) 263-2601
1245299296 CHERI M CARTWRIGHT CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1386603470 MAI T DO CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1598719668MR. CHRISTOPHER F GORTAT RPH
Individual
Pharmacist15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2650
1710934583 EVE M VANEGMOND MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2461
1134155740FEDOR OPOCHINSKY M.D.
Organization
Psychiatry & Neurology (Psychiatry)15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 466-9939
1063449825 GEORGE O KUCY MD
Individual
Pathology (Anatomic Pathology & Clinical Pathology)15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2458
1770591265MS. SUZETTE DESIREE RIPEPE JD, MS, RPH
Individual
Pharmacist15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2650
1629179668MS. PAMELA BASTION CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1407957459MR. EDWARD W. BENNETT CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1255432142MS. LORI C KUSHNER CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1114028016MS. BRENDA J LEHMAN CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2370
1487746210 COLLEEN BERTANI MSW
Individual
Social Worker15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2217
1841368297 IN SIK JEON M.D.
Individual
Anesthesiology15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
(586) 263-2300
1205997616 LEAH M LARSON CRNA
Individual
Nurse Anesthetist, Certified Registered15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2371
1528115375 NANCY A HERRINGSHAW M.D.
Individual
Anesthesiology15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 263-2373
1245387190 LI ZHANG M.D.
Individual
Anesthesiology15855 19 MILE RD
CLINTON TWP, MI 48038
(586) 273-2373

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104865443, enumerated in the NPI registry as an "individual" on June 05, 2006

The provider is located at 15855 19 Mile Rd Clinton Twp, Mi 48038 and the phone number is (586) 263-2300

The provider's speciality is Psychiatry & Neurology with taxonomy code 2084N0400X with a focus in Neurology

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on June 05, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.