Provider Demographics
NPI:1053703884
Name:BRIGHTON NEUROLOGY, PLLC
Entity type:Organization
Organization Name:BRIGHTON NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NEUROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-534-5599
Mailing Address - Street 1:7305 GRAND RIVER RD
Mailing Address - Street 2:STE 550
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7376
Mailing Address - Country:US
Mailing Address - Phone:810-534-5599
Mailing Address - Fax:810-534-5999
Practice Address - Street 1:7305 GRAND RIVER RD
Practice Address - Street 2:STE 550
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7376
Practice Address - Country:US
Practice Address - Phone:810-534-5599
Practice Address - Fax:810-534-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010739712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty