Provider Demographics
NPI:1770685877
Name:ADVANCED PAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:ADVANCED PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACPM
Authorized Official - Phone:781-665-5233
Mailing Address - Street 1:3 WOODLAND RD
Mailing Address - Street 2:STE 322
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180
Mailing Address - Country:US
Mailing Address - Phone:781-665-5233
Mailing Address - Fax:781-662-4878
Practice Address - Street 1:3 WOODLAND RD
Practice Address - Street 2:STE 322
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180
Practice Address - Country:US
Practice Address - Phone:781-665-5233
Practice Address - Fax:781-662-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9715843Medicaid
MA9715843Medicaid