Provider Demographics
NPI:1144818436
Name:NEUROSURGERY AND SPINE CARE PLLC
Entity type:Organization
Organization Name:NEUROSURGERY AND SPINE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAZEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELTAHAWY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-480-5424
Mailing Address - Street 1:1221 BOWERS ST UNIT 940
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-7037
Mailing Address - Country:US
Mailing Address - Phone:855-785-1110
Mailing Address - Fax:248-282-0866
Practice Address - Street 1:28592 ORCHARD LAKE RD STE 333
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2903
Practice Address - Country:US
Practice Address - Phone:855-785-1110
Practice Address - Fax:248-282-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144818436Medicaid