Organization
MICHIGAN BRAIN & SPINE PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NASRIN PILOTZADA RN (BUSINESS MANAGER)
(248) 440-7101
Entity
Organization
Contact information
Practice address
29355 NORTHWESTERN HWY, SUITE 130, SOUTHFIELD, MI 48034-1053
(248) 440-7101
(248) 223-9070
Mailing address
29355 NORTHWESTERN HWY, SUITE 130, SOUTHFIELD, MI 48034-1053
(248) 440-7101
(248) 223-9070
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301097955
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E03389
BLUE CROSS BLUE SHIELD PIN
MI
01
—
4301097955
LICENSE
MI
Enumeration date
04/06/2011
Last updated
02/24/2012
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