Provider Demographics
NPI:1225569437
Name:NEW WAYS PAIN MANAGEMENT
Entity Type:Organization
Organization Name:NEW WAYS PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NAYYER
Authorized Official - Middle Name:U
Authorized Official - Last Name:ISLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-556-9222
Mailing Address - Street 1:1416 FALKIRK LN NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-8299
Mailing Address - Country:US
Mailing Address - Phone:770-462-3460
Mailing Address - Fax:770-727-0809
Practice Address - Street 1:2230 TOWNE LAKE PKWY
Practice Address - Street 2:BLDG, NO. 900, SUITE 250 & 150
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5540
Practice Address - Country:US
Practice Address - Phone:404-556-9222
Practice Address - Fax:770-428-9029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA556032085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty