Healthcare Provider Details

I. General information

NPI: 1578471447
Provider Name (Legal Business Name): BRAIN AND SPINE SPECIALISTS OF MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6255 INKSTER RD STE 102
GARDEN CITY MI
48135-2538
US

IV. Provider business mailing address

1131 SILVER CREEK CT
ROCHESTER MI
48306-4284
US

V. Phone/Fax

Practice location:
  • Phone: 248-275-1144
  • Fax:
Mailing address:
  • Phone:
  • 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: MOHAN YS
Title or Position: OWNER
Credential:
Phone: 248-860-6900