Provider Demographics
NPI:1487669206
Name:PAIN & DISABILITY MANAGEMENT CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:PAIN & DISABILITY MANAGEMENT CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-635-2920
Mailing Address - Street 1:105 BRAUNLICH DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3348
Mailing Address - Country:US
Mailing Address - Phone:412-635-2920
Mailing Address - Fax:
Practice Address - Street 1:105 BRAUNLICH DR
Practice Address - Street 2:SUITE 410
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3348
Practice Address - Country:US
Practice Address - Phone:412-635-2920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046477L208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001803403Medicaid
PA368624OtherHIGHMARK
PA001803403Medicaid