Organization
MICHIGAN BRAIN AND SPINE SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA DORTON (PRACTICE ADMINISTRATOR)
(734) 502-1447
Entity
Organization
Contact information
Practice address
8179 HALCYON CT, GROSSE ILE, MI 48138-1821
(734) 502-1447
Mailing address
8179 HALCYON CT, GROSSE ILE, MI 48138-1821
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301067029
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104987298
—
MI
Enumeration date
11/15/2013
Last updated
11/15/2013
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