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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