Provider Demographics
NPI:1144659467
Name:SPARTAN SURGICAL ASSOCIATES PLC
Entity type:Organization
Organization Name:SPARTAN SURGICAL ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NOUHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-622-6879
Mailing Address - Street 1:24530 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1700
Mailing Address - Country:US
Mailing Address - Phone:313-585-9282
Mailing Address - Fax:
Practice Address - Street 1:24530 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1700
Practice Address - Country:US
Practice Address - Phone:313-585-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016167207X00000X
MI5101016096207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty