Provider Demographics
NPI:1215188644
Name:NEUROMUSCULAR DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:NEUROMUSCULAR DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-921-1444
Mailing Address - Street 1:PO BOX 10907
Mailing Address - Street 2:NEUROMONITORING
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-0907
Mailing Address - Country:US
Mailing Address - Phone:219-921-1444
Mailing Address - Fax:
Practice Address - Street 1:601 GATEWAY BLVD N
Practice Address - Street 2:NEUROMONITORING
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9658
Practice Address - Country:US
Practice Address - Phone:219-921-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty