Organization
NEUROLOGY ELECTRODIAGNOSTICS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALIL NASRALLAH M.D. (PRESIDENT)
(989) 737-1187
Entity
Organization
Contact information
Practice address
14650 W WARREN AVE, SUITE 150, DEARBORN, MI 48126-1799
(313) 581-0200
(313) 582-3300
Mailing address
2443 COPPER CREEK DR, BAY CITY, MI 48706-9071
(989) 737-1187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301079672
MI
Other
Enumeration date
09/18/2010
Last updated
06/16/2011
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