Provider Demographics
NPI:1376907956
Name:SPINE AND JOINT PAIN MANAGMENT CENTER,P.C.
Entity Type:Organization
Organization Name:SPINE AND JOINT PAIN MANAGMENT CENTER,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
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 2653
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-7107
Mailing Address - Country:US
Mailing Address - Phone:248-200-7756
Mailing Address - Fax:248-281-3535
Practice Address - Street 1:G3273 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3615
Practice Address - Country:US
Practice Address - Phone:248-234-3101
Practice Address - Fax:248-281-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097463261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center