Basic Information
| Provider Information | |||||||||
| NPI: | 1376907956 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPINE AND JOINT PAIN MANAGMENT CENTER,P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 BOWERS ST | ||||||||
| Address2: | UNIT 2653 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480127107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482007756 | ||||||||
| FaxNumber: | 2482813535 | ||||||||
| Practice Location | |||||||||
| Address1: | G3273 BEECHER RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485323615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482343101 | ||||||||
| FaxNumber: | 2482813535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2016 | ||||||||
| LastUpdateDate: | 04/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | AHSAN | ||||||||
| AuthorizedOfficialFirstName: | MUHAMMAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9376733983 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 4301097463 | MI | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.