Provider Demographics
NPI:1316032550
Name:DELAWARE INSTITUTE OF PAIN MANAGEMENT &ANTI AGING MEDICINE LLC
Entity Type:Organization
Organization Name:DELAWARE INSTITUTE OF PAIN MANAGEMENT &ANTI AGING MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AMEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-359-3974
Mailing Address - Street 1:6 E CAMDEN WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1301
Mailing Address - Country:US
Mailing Address - Phone:302-698-3994
Mailing Address - Fax:302-698-3952
Practice Address - Street 1:6 E CAMDEN WYOMING AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1301
Practice Address - Country:US
Practice Address - Phone:302-698-3994
Practice Address - Fax:302-698-3952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0005695207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00B795D89Medicare PIN
DEG01189Medicare PIN