Provider Demographics
NPI:1164793683
Name:COMPREHENSIVE PAIN MANAGEMENT CENTER, INC.
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN MANAGEMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:KAMRAN
Authorized Official - Last Name:AHSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-673-3983
Mailing Address - Street 1:1221 BOWERS ST
Mailing Address - Street 2:UNIT 2365
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-7107
Mailing Address - Country:US
Mailing Address - Phone:937-673-3983
Mailing Address - Fax:989-790-0261
Practice Address - Street 1:4677 TOWNE CENTRE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2846
Practice Address - Country:US
Practice Address - Phone:937-673-3983
Practice Address - Fax:987-790-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097463208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty