Healthcare Provider Details

I. General information

NPI: 1720629157
Provider Name (Legal Business Name): COMMERCE SPORTS AND SPINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
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: 616-485-0584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ARVINDER DHILLON
Title or Position: MEDICAL DOCTOR
Credential:
Phone: 781-710-3843