Provider Demographics
NPI:1144818436
Name:NEUROSURGERY AND SPINE CARE PLLC
Entity type:Organization
Organization Name:NEUROSURGERY AND SPINE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAZEM
Authorized Official - Middle Name:ABDALLA
Authorized Official - Last Name:ELTAHAWY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-443-8942
Mailing Address - Street 1:1332 MARYLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-4125
Mailing Address - Country:US
Mailing Address - Phone:313-443-8942
Mailing Address - Fax:
Practice Address - Street 1:23700 ORCHARD LAKE RD STE E
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2559
Practice Address - Country:US
Practice Address - Phone:855-785-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty