Organization
THE NEUROLOGY CENTER PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIMOSTHENIS COSTANTINOS DAFNIS M.D. (OWNER)
(517) 278-3412
Entity
Organization
Contact information
Practice address
23 N HANCHETT ST, COLDWATER, MI 49036-1652
(517) 278-3412
(517) 278-6115
Mailing address
23 N HANCHETT ST, COLDWATER, MI 49036-1652
(517) 278-3412
(517) 278-6115
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301073404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0530097
IBA
MI
01
—
130019309
RAILROAD MEDICARE
MI
01
—
1301200592
BLUE CROSS BLUE SHIELD MICHIGAN
MI
Enumeration date
04/29/2008
Last updated
09/02/2010
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