Provider Demographics
NPI:1295066728
Name:NEUMEDICINE TECHNOLOGIES ASSOCIATES
Entity type:Organization
Organization Name:NEUMEDICINE TECHNOLOGIES ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-563-8835
Mailing Address - Street 1:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48376-0756
Mailing Address - Country:US
Mailing Address - Phone:877-563-8633
Mailing Address - Fax:419-861-7611
Practice Address - Street 1:24792 SUTHERLAND DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-3140
Practice Address - Country:US
Practice Address - Phone:877-563-8633
Practice Address - Fax:419-861-7611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty