MHNI PAIN MANAGEMENT, P.C.

Provider Demographics

• NPI: 1144375999
• Name: MHNI PAIN MANAGEMENT, P.C.
• Entity Type: Organization
• Organization Name: MHNI PAIN MANAGEMENT, P.C.
• Other - Org Name: LENAWEE PAIN SPECIALISTS
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: ADMINISTRATOR
• Authorized Official - First Name: SCOTT
• Authorized Official - Last Name: MADDEN
• Authorized Official - Phone: 734-677-6000
• Mailing Address - Street 1: 3120 PROFESSIONAL DRIVE
• Mailing Address - City: ANN ARBOR
• Mailing Address - State: MI
• Mailing Address - Zip Code: 48104
• Mailing Address - Country: US
• Mailing Address - Phone: 734-677-6000
• Mailing Address - Fax: 734-677-2422
• Practice Address - Street 1: 3120 PROFESSIONAL DRIVE
• Practice Address - City: ANN ARBOR
• Practice Address - State: MI
• Practice Address - Zip Code: 48104
• Practice Address - Country: US
• Practice Address - Phone: 734-677-6000
• Practice Address - Fax: 734-677-2422
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-24
• Last Update Date: 2013-07-24

Provider Licenses

State	License ID	Taxonomies
MI	6301010686	103T00000X
MI	6301006998	103T00000X
MI	4301085148	207LP2900X
MI	4301029842	2084N0400X
MI	5601002855	363A00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207LP2900X	Allopathic & Osteopathic Physicians	Anesthesiology	Pain Medicine	Group - Multi-Specialty
No	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	2084N0400X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Neurology	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MI	4758007	Medicaid
MI	4758007	Medicaid
MI	ON56210	Medicare PIN
MI	ON90990	Medicare PIN
MI	0N56210	Medicare PIN