Michigan Orthopedic Spine & Interventionalist PLLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

MICHIGAN ORTHOPEDIC SPINE & INTERVENTIONALIST PLLC

Practice address

17290 Stonebrook Dr
Northville, MI 48168-4324

Phone

(989) 600-0242

NPI assigned

Jan 16, 2019

Last updated

Jan 16, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bachu Abraham, MD

Title

Owner

Phone

(989) 600-0242

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1609340215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250665",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483250665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17290 STONEBROOK DR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481684324",
            "telephone_number": "989-600-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN ORTHOPEDIC SPINE & INTERVENTIONALIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "BACHU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-600-0242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Miazgowicz
• Mary A Miceli, PA-C
• Michigan Dental Providers, P.C. (DentalWorks)
• Michigan Fyzpt-II Fyzical
• Michigan Ophthalmology Specialists, PLLC
• Michigan Telerad LLC
• Midwest Anesthesia Resources, Inc.
• Michelle Mikha
• Haley Elizabeth Mikkelsen
• Hannah Milavec, LLMSW

• Pain Clinic/Center in Northville, MI
• Providers in Northville, MI by specialty
• Pain Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.