Healthcare Provider Details

I. General information

NPI: 1396393856
Provider Name (Legal Business Name): SPHERE ORTHOPEDICS AND REGENERATIVE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E 9 MILE RD
FERNDALE MI
48220-1934
US

IV. Provider business mailing address

911 E 9 MILE RD
FERNDALE MI
48220-1934
US

V. Phone/Fax

Practice location:
  • Phone: 248-336-4000
  • Fax:
Mailing address:
  • Phone: 248-336-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KHALED J SALEH
Title or Position: CEO AND MEDICAL DIRECTOR
Credential: M.D.
Phone: 248-336-4000