Healthcare Provider Details

I. General information

NPI: 1851100119
Provider Name (Legal Business Name): THE KNEE PAIN CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35455 GARFIELD RD STE 100
CLINTON TOWNSHIP MI
48035-2500
US

IV. Provider business mailing address

35455 GARFIELD RD STE 100
CLINTON TOWNSHIP MI
48035-2500
US

V. Phone/Fax

Practice location:
  • Phone: 586-600-5633
  • Fax: 586-600-5634
Mailing address:
  • Phone: 586-600-5633
  • Fax: 586-600-5634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: EDDIE EL-YUSSIF
Title or Position: OWNER
Credential: DO
Phone: 586-600-5634