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General NPI Number Information
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NPI Number | 1326211715
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Entity Type | Organization
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Legal Business Name | CLINICAL NEUROPHYSIOLOGY SERVICES, PC
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 44344 DEQUINDRE RD STE 360
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-1041
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Country | US
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Telephone | 586-254-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 44344 DEQUINDRE RD STE 360
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-1041
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Country | US
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Telephone | 586-254-0707
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. R BART SANGAL
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Credential | M.D.
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Telephone | 586-254-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | 4301046211
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License Number State | MI
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