Pain Specialist Of Michigan, PLLC
Pain Medicine, Interventional Pain Medicine in Novi, MI. Organization (NPI-2).
NPI number1306297817
StatusActive
Last updated in NPPESSep 4, 2018
Details
- NPI
- 1306297817
- Entity type
- Organization (NPI-2)
- Legal business name
- Pain Specialist Of Michigan, PLLC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2016
- Last updated
- Sep 4, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | – | – | Yes |
| 208100000X | Physical Medicine & Rehabilitation | – | – | |
| 208VP0000X | – | – |
Practice location
39475 Lewis DrSuite 200
Novi, MI 48377
Phone 410-571-2946
Mailing address
201 Defense HwySuite 205
Annapolis, MD 21401-8943
Other practice locations
12660 10 Mile Rd
South Lyon, MI 48178-9141
South Lyon, MI 48178-9141
Phone 248-697-2880 · Fax 248-856-2544
Authorized official
Damean Freas
Ceo
4105712946
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