Provider Demographics
NPI:1609915941
Name:A & A PAIN INSTITUTE
Entity Type:Organization
Organization Name:A & A PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUNTEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS
Authorized Official - Phone:314-692-7246
Mailing Address - Street 1:456 N NEW BALLAS RD
Mailing Address - Street 2:SUITE 154
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6831
Mailing Address - Country:US
Mailing Address - Phone:314-692-7246
Mailing Address - Fax:
Practice Address - Street 1:456 N NEW BALLAS RD
Practice Address - Street 2:SUITE 154
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6831
Practice Address - Country:US
Practice Address - Phone:314-692-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8N65208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE68043Medicare UPIN