Healthcare Provider Details

I. General information

NPI: 1548880487
Provider Name (Legal Business Name): COMMERCE SPORTS AND SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29877 TELEGRAPH RD STE 400
SOUTHFIELD MI
48034-7661
US

IV. Provider business mailing address

29877 TELEGRAPH RD STE 400
SOUTHFIELD MI
48034-7661
US

V. Phone/Fax

Practice location:
  • Phone: 248-294-0539
  • Fax: 248-934-1390
Mailing address:
  • Phone: 248-294-0539
  • Fax: 248-934-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARVINDER DHILLON
Title or Position: OWNER
Credential: MD
Phone: 616-485-0584