Healthcare Provider Details

I. General information

NPI: 1710355482
Provider Name (Legal Business Name): MICHIGAN CENTER FOR REGENERATIVE MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BARCLAY CIR STE A
ROCHESTER HILLS MI
48307-5816
US

IV. Provider business mailing address

355 BARCLAY CIR STE A
ROCHESTER HILLS MI
48307-5816
US

V. Phone/Fax

Practice location:
  • Phone: 248-705-3287
  • Fax: 855-711-5063
Mailing address:
  • Phone: 248-216-1008
  • Fax: 855-711-5063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number4301083370
License Number StateMI

VIII. Authorized Official

Name: DR. THOMAS STANLEY NABITY JR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 248-259-0066