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General NPI Number Information
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NPI Number | 1629953567
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Entity Type | Organization
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Legal Business Name | ENSPA PLLC
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 34020 7 MILE RD STE 101
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City | LIVONIA
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State | MI
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Zip | 48152-3093
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Country | US
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Telephone | 248-480-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 BOWERS ST UNIT 940
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City | BIRMINGHAM
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State | MI
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Zip | 48012-7037
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Country | US
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Telephone | 313-443-8942
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAZEM ELTAHAWY
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Credential | MD
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Telephone | 313-443-8942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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