Healthcare Provider Details

I. General information

NPI: 1023173978
Provider Name (Legal Business Name): NEUROMED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 AVIS DR
ANN ARBOR MI
48108-9649
US

IV. Provider business mailing address

812 AVIS DR
ANN ARBOR MI
48108-9649
US

V. Phone/Fax

Practice location:
  • Phone: 800-638-7564
  • Fax: 866-634-2766
Mailing address:
  • Phone: 800-638-7564
  • Fax: 866-634-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: KAREN A WESCOTT
Title or Position: AR SUPERVISOR
Credential:
Phone: 734-213-3931