Organization
SOUTHFIELD NEUROLOGICAL ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE H KOLE MD (PRESIDENT)
(248) 559-3150
Entity
Organization
Contact information
Practice address
22250 PROVIDENCE DR, SUITE 402, SOUTHFIELD, MI 48075-4825
(248) 559-3150
(248) 559-8218
Mailing address
22250 PROVIDENCE DR, SUITE 402, SOUTHFIELD, MI 48075-4825
(248) 559-3150
(248) 559-8218
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BK027608
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1059871
—
MI
Enumeration date
05/24/2007
Last updated
06/18/2010
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