Provider Demographics
NPI:1477830958
Name:MIDWEST NEURODIAGNOSTICS
Entity Type:Organization
Organization Name:MIDWEST NEURODIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SCHIFF
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:512-844-4120
Mailing Address - Street 1:3724 EXECUTIVE CENTER DR STE 163
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1631
Mailing Address - Country:US
Mailing Address - Phone:512-873-3344
Mailing Address - Fax:512-873-3347
Practice Address - Street 1:3724 EXECUTIVE CENTER DR STE 163
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1631
Practice Address - Country:US
Practice Address - Phone:512-873-3344
Practice Address - Fax:512-873-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty