# MICHIGAN NEUROLOGY ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629467204
- **Authorized official:** THOMAS GIANCARLO (PRESIDENT)
- **Authorized official phone:** (586) 445-9900

## Contact information

- **Practice address:** 34025 HARPER AVE, CLINTON TOWNSHIP, MI 48035-3737
- **Practice address phone:** (586) 445-9900
- **Practice address fax:** (586) 464-2231
- **Mailing address:** 34025 HARPER AVE, CLINTON TOWNSHIP, MI 48035-3737
- **Mailing address phone:** (586) 445-9900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 4301105998 | MI | Yes |

## Other

- **Enumeration date:** 01/20/2015
- **Last updated:** 01/20/2015