Organization
SPECTRUM SURGICAL SPECIALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANISH KHARE (M.D.)
(313) 920-5543
Entity
Organization
Contact information
Practice address
6001 W OUTER DR, SUITE 320, DETROIT, MI 48235-2614
(313) 920-5543
Mailing address
3181 TROY DR, TROY, MI 48083-5098
(313) 920-5543
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301086474
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N30540
MEDICARE
MI
Enumeration date
05/02/2014
Last updated
05/06/2014
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