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General NPI Number Information
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NPI Number | 1558432203
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Entity Type | Organization
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Legal Business Name | WEST MICHIGAN NEUROLOGICAL ASSOCIATES PLC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 957 BROOKHAVEN CT BLDG F
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City | MUSKEGON
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State | MI
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Zip | 49442-3890
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Country | US
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Telephone | 855-231-9662
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Fax | 877-252-7403
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Provider Business Mailing Address
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Address Line | 957 BROOKHAVEN CT BLDG F
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City | MUSKEGON
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State | MI
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Zip | 49442-3890
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Country | US
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Telephone | 855-231-9662
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Fax | 877-252-7403
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY G GURDEN
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Credential | MD
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Telephone | 855-231-9662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | GG033978
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License Number State | MI
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