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Great Lakes Pediatric Neurology
Medical Specialty Clinic/Center in Dearborn, Michigan
NPI 1417017476

Great Lakes Pediatric Neurology is a Medical Specialty Clinic/Center based in Dearborn, MI and is specialized in Medical Specialty. Great Lakes Pediatric Neurology practices in Dearborn, MI. The NPI Number for Great Lakes Pediatric Neurology is 1417017476 and holds a License No. (Michigan).

The current practice location address for Great Lakes Pediatric Neurology is 1331 Monroe St, Dearborn, MI and can be reached out via phone at 248-851-1700 and via fax at 248-851-3830.

Location: 1331 Monroe St, Dearborn, MI, 48124-2888
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417017476
Provider Name
Great Lakes Pediatric Neurology
Credential
Provider Entity Type
Organization
Address
1331 Monroe St, Dearborn, MI, 48124-2888
Phone Number
248-851-1700
Fax Number
248-851-3830
Provider Enumeration Date
12/11/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1331 Monroe St
City
Dearborn
State
Michigan
Zip
48124-2888
Phone Number
248-851-1700
Fax Number
248-851-3830
person
Provider Business Mailing Address Details
Address
1331 Monroe St
City
Dearborn
State
Michigan
Zip
48124-2888
Phone Number
248-851-1700
Fax Number
248-851-3830
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
()
Definition
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).
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