Organization
MICHIGAN NEUROSURGICAL INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA V SCOTT (PRACTICE MANAGER)
(810) 606-7112
Entity
Organization
Contact information
Practice address
4620 GENESYS PKWY, GRAND BLANC, MI 48439-8067
(810) 606-7200
(810) 606-7115
Mailing address
4620 GENESYS PKWY, GRAND BLANC, MI 48439-8067
(810) 606-7200
(810) 606-7115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540B515610
BCBSM PIN
—
Enumeration date
04/28/2008
Last updated
01/21/2021
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