Organization
MICHIGAN NEUROLOGY ASSOCIATES DME
Active
Organization
MICHIGAN NEUROLOGY ASSOCIATES DME
Active
Parent organization
MICHIGAN NEUROLOGY ASSOCIATES, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHIGAN NEUROLOGY ASSOCIATES, PC
Authorized official
THOMAS GIANCARLO DO (PRESIDENT, MNA)
(586) 445-9900
Entity
Organization
Contact information
Practice address
34025 HARPER AVE, CLINTON TWP, MI 48035-3737
(586) 445-9900
Mailing address
34025 HARPER AVE, CLINTON TWP, MI 48035-3737
(586) 445-9900
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5101008571
MI
332B00000X
Durable Medical Equipment & Medical Supplies
5101008581
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540E007730
BCBSM
MI
Enumeration date
11/18/2008
Last updated
08/29/2016
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