=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184598088
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEUROSURGERY AND SPINE CARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2025
-----------------------------------------------------
Last Update Date | 10/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34020 7 MILE RD STE 101
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-3093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-516-5016
-----------------------------------------------------
Fax | 248-516-5017
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34020 7 MILE RD STE 101
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48152-3093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-516-5016
-----------------------------------------------------
Fax | 248-516-5017
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MD
-----------------------------------------------------
Name | HAZEM ELTAHAWY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 248-480-5424
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------