Provider Demographics
NPI:1831494707
Name:SOUTHERN DELAWARE PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:SOUTHERN DELAWARE PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-538-7055
Mailing Address - Street 1:1979 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-5811
Mailing Address - Country:US
Mailing Address - Phone:302-538-7055
Mailing Address - Fax:302-538-7065
Practice Address - Street 1:1979 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-5811
Practice Address - Country:US
Practice Address - Phone:302-538-7055
Practice Address - Fax:302-538-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty