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General NPI Number Information
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NPI Number | 1174554778
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Entity Type | Organization
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Legal Business Name | UNIVERSITY NEUROLOGIC SURGEONS
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4160 JOHN R. ST. SUITE 925
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-831-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 WOODWARD AVE. SUITE 702
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIR
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Name | MURALI GUTHIKONDA
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Credential |
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Telephone | 313-966-0342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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