Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Great Lakes Pediatric Neurology

Organization Medical Specialty Clinic/Center · NPI 1417017476

Great Lakes Pediatric Neurology is a Medical Specialty Clinic/Center in Dearborn, Michigan. Registered with an NPI since 2006.

In the registry since
2006
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Practice location Address checks out

1331 Monroe St
Dearborn, MI 48124-2888
Phone: (248) 851-1700
Fax: (248) 851-3830
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X

Record details

NPI number1417017476
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Yasser Awaad — President · (248) 851-1700
NPI enumeratedDecember 11, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1331 Monroe St, Dearborn, MI 48124-2888

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