Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Joint and Spine PLLC

Organization Interventional Pain Medicine Physician · NPI 1790611838

Revive Joint and Spine PLLC is an Interventional Pain Medicine Physician in Dearborn Heights, Michigan. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

23902 Ford Rd Ste A
Dearborn Heights, MI 48127-3289
Phone: (313) 777-7246
Fax: (313) 672-6222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X

Record details

NPI number1790611838
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mustafa Shukr — Medical Director · (313) 777-7246
NPI enumeratedJune 18, 2026
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026
Mailing address23902 Ford Rd Ste A, Dearborn Heights, MI 48127-3289

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