Organization
REVIVE JOINT AND SPINE PLLC
Active
Organization
REVIVE JOINT AND SPINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSTAFA SHUKR MD (MEDICAL DIRECTOR)
(313) 777-7246
Entity
Organization
Contact information
Practice address
23902 FORD RD STE A, DEARBORN HEIGHTS, MI 48127-3289
(313) 777-7246
(313) 672-6222
Mailing address
23902 FORD RD STE A, DEARBORN HEIGHTS, MI 48127-3289
(313) 777-7246
(313) 672-6222
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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