Provider Demographics
NPI:1629953567
Name:ENSPA PLLC
Entity type:Organization
Organization Name:ENSPA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
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:313-443-8942
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:313-443-8942
Mailing Address - Fax:
Practice Address - Street 1:34020 7 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3093
Practice Address - Country:US
Practice Address - Phone:248-480-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROSURGERY AND SPINE CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty