Organization
SOUTHFIELD REGENERATIVE MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN HIJAZI DO (OWNER)
(313) 284-9433
Entity
Organization
Contact information
Practice address
17220 W 12 MILE RD STE 200, SOUTHFIELD, MI 48076-2141
(313) 284-9433
(313) 284-3180
Mailing address
17220 W 12 MILE RD STE 205, SOUTHFIELD, MI 48076-2114
(313) 284-9433
(313) 284-3180
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
03/22/2024
Last updated
04/05/2024
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