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Organization

GREAT LAKES NEUROLOGY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN HUDER (PRESIDENT)
(231) 487-3970
Entity
Organization

Contact information

Practice address
932 SPRING ST STE 102, PETOSKEY, MI 49770-2286
(231) 487-3970
Mailing address
932 SPRING ST STE 102, PETOSKEY, MI 49770-2855

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
SH067274
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3514160
MI
Enumeration date
10/25/2006
Last updated
02/21/2012
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