Provider Demographics
NPI:1164684338
Name:ADVANCED COMPREHENSIVE PAIN MANAGEMENT, LLC
Entity Type:Organization
Organization Name:ADVANCED COMPREHENSIVE PAIN MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALAMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-995-4500
Mailing Address - Street 1:24400 CHAGRIN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5632
Mailing Address - Country:US
Mailing Address - Phone:440-995-4500
Mailing Address - Fax:440-995-4585
Practice Address - Street 1:24400 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5642
Practice Address - Country:US
Practice Address - Phone:440-995-4500
Practice Address - Fax:440-995-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-071836208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6330010001Medicare NSC