Organization
EASTSIDE NEUROSURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN A GRAHAM (MANAGER)
(313) 343-8833
Entity
Organization
Contact information
Practice address
22201 MOROSS RD, SUITE 352, DETROIT, MI 48236-2169
(313) 343-7900
(313) 343-7001
Mailing address
22201 MOROSS RD, SUITE 352, DETROIT, MI 48236-2169
(313) 343-7900
(313) 343-7001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301406954
MI
Other
Enumeration date
09/12/2007
Last updated
12/10/2010
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