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Organization

BLOOMFIELD NEUROLOGY CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LIONEL GLASS M.D. (PRESIDENT)
(248) 338-8400
Entity
Organization

Contact information

Practice address
43494 WOODWARD AVE, SUITE 103, BLOOMFIELD HILLS, MI 48302-5052
(248) 338-8400
(248) 338-8151
Mailing address
43494 WOODWARD AVE, SUITE 103, BLOOMFIELD HILLS, MI 48302-5052
(248) 338-8400
(248) 338-8151

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301031094
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130635749
BCBS
MI
05
3504593
MI
Enumeration date
10/24/2006
Last updated
04/15/2009
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