| NPI | 1174004261 |
|---|---|
| Doing Business As | NORTHWESTERN NEUROLOGY |
| Entity Type | Organization |
| Authorized Contact | MARY E PIGEON Payor Credentialing & Contract Spec 802-524-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |