Organization
MICHIGAN NEUROLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIRISH MANGALICK MD (MEDICAL DIRECTOR)
(734) 284-2600
Entity
Organization
Contact information
Practice address
1848 BIDDLE AVE., SUITE 101, WYANDOTTE, MI 48192-4064
(734) 284-2600
(734) 284-8666
Mailing address
1848 BIDDLE AVE., SUITE 101, WYANDOTTE, MI 48192-4064
(734) 284-2600
(734) 284-8666
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
GM034377
MI
174400000X
Specialist
MM07284
MI
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130H222940
BCN GROUP
MI
05
—
1326051665
—
MI
Enumeration date
08/15/2006
Last updated
07/11/2011
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