Provider Demographics
NPI:1366693616
Name:MICHIGAN INSTITUTE OF PAIN AND HEADACHE, PC
Entity Type:Organization
Organization Name:MICHIGAN INSTITUTE OF PAIN AND HEADACHE, PC
Other - Org Name:METRO PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZIH
Authorized Official - Middle Name:SABAH
Authorized Official - Last Name:ISKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-401-9257
Mailing Address - Street 1:18161 W 13 MILE RD
Mailing Address - Street 2:STE C
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1113
Mailing Address - Country:US
Mailing Address - Phone:216-401-9257
Mailing Address - Fax:248-646-5871
Practice Address - Street 1:18161 W 13 MILE RD
Practice Address - Street 2:STE C
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1113
Practice Address - Country:US
Practice Address - Phone:216-401-9257
Practice Address - Fax:248-646-5871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain