Provider Demographics
NPI:1407338742
Name:PAIN SPECIALIST OF MICHIGAN, PLLC
Entity Type:Organization
Organization Name:PAIN SPECIALIST OF MICHIGAN, PLLC
Other - Org Name:KURE PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRITNI
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-837-9913
Mailing Address - Street 1:201 DEFENSE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7096
Mailing Address - Country:US
Mailing Address - Phone:410-571-2946
Mailing Address - Fax:
Practice Address - Street 1:12660 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-9141
Practice Address - Country:US
Practice Address - Phone:248-697-2880
Practice Address - Fax:248-856-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty