Provider Demographics
NPI:1730472218
Name:TWIN CITIES PAIN MANAGEMENT, PLLC
Entity Type:Organization
Organization Name:TWIN CITIES PAIN MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STARCHOOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-853-7226
Mailing Address - Street 1:4444 W 76TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5177
Mailing Address - Country:US
Mailing Address - Phone:952-831-7246
Mailing Address - Fax:
Practice Address - Street 1:4444 W 76TH ST STE 500
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5177
Practice Address - Country:US
Practice Address - Phone:952-831-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty