| Lucid Neurology | |
|
26222 Telegraph Road Suite 300 Southfield MI 48033 | |
| (248) 864-8752 | |
| (248) 920-0744 |
| Full Name | Lucid Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 26222 Telegraph Road, Southfield, Michigan |
| Authorized Official Name and Position | Kevin Kachan (MANAGER/AUTHORIZED OFFICAL) |
| Authorized Official Contact | 2482503393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucid Neurology 26222 Telegraph Road Suite 300 Southfield MI 48033 Ph: (248) 864-8752 | Lucid Neurology 26222 Telegraph Road Suite 300 Southfield MI 48033 Ph: (248) 864-8752 |
| NPI Number | 1992261481 |
|---|---|
| Provider Enumeration Date | 02/20/2019 |
| Last Update Date | 09/16/2022 |
| Certification Date | 09/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992261481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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