Provider Demographics
NPI:1649740747
Name:MICHIGAN INSTITUTE FOR INTERVENTIONAL PAIN PLLC
Entity Type:Organization
Organization Name:MICHIGAN INSTITUTE FOR INTERVENTIONAL PAIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASBAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-227-7828
Mailing Address - Street 1:1234 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1433
Mailing Address - Country:US
Mailing Address - Phone:248-319-6630
Mailing Address - Fax:248-319-6631
Practice Address - Street 1:1234 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1433
Practice Address - Country:US
Practice Address - Phone:248-319-6630
Practice Address - Fax:248-319-6631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty