Provider Demographics
NPI:1891306114
Name:SPINE AND JOINT INSTITUTE OF MICHIGAN, LLC
Entity Type:Organization
Organization Name:SPINE AND JOINT INSTITUTE OF MICHIGAN, LLC
Other - Org Name:SPINE AND JOINT SURGICAL INSTITUTE OF MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:POSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-350-3533
Mailing Address - Street 1:5140 COOLIDGE HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1030
Mailing Address - Country:US
Mailing Address - Phone:248-934-0000
Mailing Address - Fax:
Practice Address - Street 1:5140 COOLIDGE HWY, STE 200
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-483-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical