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Organization
MD SPINE AND HEALTH CENTER LLC
Active
Organization
MD SPINE AND HEALTH CENTER LLC
Active
Other names
MDSH
Organization subpart
No
Provider details
NPI number
Authorized official
SAM HACKETTE MD (OWNER)
(727) 422-4688
Entity
Organization
Contact information
Practice address
27789 MOUND RD STE 100, WARREN, MI 48092-2697
(313) 209-3353
Mailing address
PO BOX 880, STERLING HEIGHTS, MI 48311-0880
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/17/2017
Last updated
04/30/2021
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