Organization · Type 2 NPI
Great Lakes Pediatric Neurology
Medical Specialty Clinic/Center · Dearborn, MI
Practice location
1331 Monroe St
Dearborn, MI 48124-2888
Fax (248) 851-3830
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | None listed |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
3 other providers at this address
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About NPI 1417017476
Great Lakes Pediatric Neurology's National Provider Identifier is 1417017476, issued on Dec 11, 2006. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in Dearborn, MI. The record was last updated on Aug 22, 2020.