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General NPI Number Information
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NPI Number | 1144659467
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Entity Type | Organization
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Legal Business Name | SPARTAN SURGICAL ASSOCIATES PLC
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 24530 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48124-1700
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Country | US
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Telephone | 313-585-9282
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Fax |
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Provider Business Mailing Address
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Address Line | 24530 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48124-1700
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Country | US
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Telephone | 313-585-9282
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NOUHA ALAMMAR
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Credential | D.O.
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Telephone | 313-622-6879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 5101016167
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 5101016096
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License Number State | MI
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