Organization
NORTHWEST NEUROLOGY PC
Active
Other names
NORTHWEST NEUROLOGY AND NEURODIAGNOSTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TESSY C JENKINS MD (PRESIDENT)
(248) 208-9215
Entity
Organization
Contact information
Practice address
27200 LAHSER RD, SUITE 100, SOUTHFIELD, MI 48034-2137
(248) 208-9215
(248) 208-9217
Mailing address
27200 LAHSER RD, SUITE 100, SOUTHFIELD, MI 48034-2137
(248) 208-9215
(248) 208-9217
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301058568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4639614
—
MI
Enumeration date
03/19/2007
Last updated
10/18/2010
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