Healthcare Provider Details

I. General information

NPI: 1164635025
Provider Name (Legal Business Name): NEUROMUSCULAR SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24901 NORTHWESTERN HWY SUITE 101
SOUTHFIELD MI
48075-2203
US

IV. Provider business mailing address

24901 NORTHWESTERN HWY SUITE 101
SOUTHFIELD MI
48075-2203
US

V. Phone/Fax

Practice location:
  • Phone: 248-358-3000
  • Fax: 248-358-3001
Mailing address:
  • Phone: 248-358-3000
  • Fax: 248-358-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WASIM RATHUR
Title or Position: MEMBER
Credential: M.D.
Phone: 248-358-3000