Organization
NEUROWAVE DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANNIE CLARK (CEO)
(770) 557-0885
Entity
Organization
Contact information
Practice address
2227 IDLEWOOD RD, SUITE 400, TUCKER, GA 30084-4827
(770) 557-0885
(770) 557-0315
Mailing address
PO BOX 930905, NORCROSS, GA 30003-0905
(770) 557-0885
(770) 557-0315
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up