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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