Organization
NEURODIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MARTIN (ADMINISTRATOR)
(248) 414-5367
Entity
Organization
Contact information
Practice address
1200 W 9 MILE RD, FERNDALE, MI 48220-1299
(248) 414-5367
Mailing address
PO BOX 2152, SOUTHGATE, MI 48195-4152
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301052678
MI
Other
Enumeration date
09/28/2007
Last updated
06/20/2008
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