Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Grandrapids Regenerative Center PLLC

Organization Pain Medicine Physician · NPI 1013820059

Grandrapids Regenerative Center PLLC provides Pain Medicine Physician services in Southfield, 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

17220 W 12 Mile Rd Ste 129
Southfield, MI 48076-2114
Phone: (617) 819-5841
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X

Record details

NPI number1013820059
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Hijazi — Owner · (617) 819-5841
NPI enumeratedSeptember 22, 2026
Last updated in NPPESSeptember 22, 2026
Certification dateSeptember 22, 2026
Mailing address17220 W 12 Mile Rd Ste 129, Southfield, MI 48076-2114

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