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Organization

ADVANCED NEUROLOGIC ASSOCIATES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN BENEDICT MD (PRESIDENT)
(419) 483-2403
Entity
Organization

Contact information

Practice address
1250 FULTON ST, PORT CLINTON, OH 43452-9296
(419) 483-2403
(419) 484-1203
Mailing address
5433 STATE ROUTE 113, BELLEVUE, OH 44811-9708
(419) 483-2403
(419) 484-1203

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2383620
OH
01
CL1664
RAILROAD MEDICARE
OH
Enumeration date
08/02/2010
Last updated
12/07/2010
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