Great Lakes Pediatric Neurology

NPI 1417017476 - Clinic/Center - 261QM2500X

NPI Details
NPI 1417017476
Enumeration Date 12/11/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name YASSER YASSER
Position PRESIDENT
Phone (248) 851-1700
Fax (248) 851-3830
Practice Location
1331 MONROE ST
DEARBORN MI, 48124-2888, US
Phone (248) 851-1700
Fax (248) 851-3830
Business Location
1331 MONROE ST
DEARBORN MI, 48124-2888, US
Phone (248) 851-1700
Fax (248) 851-3830
Toxanomy
Taxonomy Code 261QM2500X
License State
License Number
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According to our database, Great Lakes Pediatric Neurology NPI is 1417017476, taxonomy code is 261QM2500X Great Lakes Pediatric Neurology physically located at 1331 Monroe St, Dearborn MI, 48124-2888. NPI Number 1033115704 has the healthcare provider type.

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1417017476 NPI number is provided on an as is basis without warranty of any kind. 1417017476 is maintained by the National Plan & Provider Enumeration System. The contents of Great Lakes Pediatric Neurology are for informational purposes only.