Provider Demographics
NPI:1396393856
Name:SPHERE ORTHOPEDICS AND REGENERATIVE HEALTH PLLC
Entity Type:Organization
Organization Name:SPHERE ORTHOPEDICS AND REGENERATIVE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-336-4000
Mailing Address - Street 1:911 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1934
Mailing Address - Country:US
Mailing Address - Phone:248-336-4000
Mailing Address - Fax:
Practice Address - Street 1:911 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1934
Practice Address - Country:US
Practice Address - Phone:248-336-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty