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

Revive Sports & Spine Management

Organization Medical Specialty Clinic/Center · NPI 1679195465

Revive Sports & Spine Management is a Medical Specialty Clinic/Center in Warren, Michigan. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

27253 Van Dyke Ave
Warren, MI 48093-2858
Phone: (586) 486-4520
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X

Record details

NPI number1679195465
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Haroun Fetteh — Doctor/Owner · (313) 790-3998
NPI enumeratedMay 14, 2020
Last updated in NPPESMay 14, 2020
Certification dateMay 14, 2020
Mailing addressPo Box 7175, Dearborn, MI 48121-7175

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