Organization
NEURO TEAM ONE PLLC
Active
Organization
NEURO TEAM ONE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW RATHNASAMY XAVIER MD (MEMBER)
(248) 621-9100
Entity
Organization
Contact information
Practice address
31500 TELEGRAPH RD STE 115, BINGHAM FARMS, MI 48025-4302
(248) 621-9100
Mailing address
6632 TELEGRAPH RD STE 204, BLOOMFIELD HILLS, MI 48301-3012
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301088851
MI
2084V0102X
Vascular Neurology Physician
4301088851
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4950019
—
MI
Enumeration date
11/01/2016
Last updated
07/08/2020
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