Healthcare Provider Details

I. General information

NPI: 1063386936
Provider Name (Legal Business Name): NEUROSURGERY AND SPINE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42645 GARFIELD RD STE 103
CLINTON TOWNSHIP MI
48038-5022
US

IV. Provider business mailing address

34020 7 MILE RD STE 101
LIVONIA MI
48152-3093
US

V. Phone/Fax

Practice location:
  • Phone: 586-286-7246
  • Fax: 586-329-4757
Mailing address:
  • Phone: 248-516-5016
  • Fax: 248-516-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HAZEM ELTAHAWY
Title or Position: OWNER/MD
Credential:
Phone: 248-480-5424