Organization
MICHIGAN SPINE AND BRAIN SURGEONS, PLLC
Active
Organization
MICHIGAN SPINE AND BRAIN SURGEONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TECK MUN SOO M.D. (PRESIDENT)
(248) 569-7745
Entity
Organization
Contact information
Practice address
22250 PROVIDENCE DR, SUITE 601, SOUTHFIELD, MI 48075-4825
(248) 569-7745
(248) 569-4539
Mailing address
22250 PROVIDENCE DR, SUITE 601, SOUTHFIELD, MI 48075-4825
(248) 569-7745
(248) 569-4539
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F32853
BLUE CROSS
MI
Enumeration date
11/03/2005
Last updated
07/14/2011
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