Healthcare Provider Details

I. General information

NPI: 1912829284
Provider Name (Legal Business Name): LANSING NEUROSURGERY AND SPINE INSTITUTE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6402 WOODCLIFFE LN
EAST LANSING MI
48823-9781
US

IV. Provider business mailing address

6402 WOODCLIFFE LN
EAST LANSING MI
48823-9781
US

V. Phone/Fax

Practice location:
  • Phone: 517-614-1565
  • Fax:
Mailing address:
  • Phone: 517-614-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED H ELNABTITY
Title or Position: SOLE MEMBER
Credential:
Phone: 517-614-1565