Provider Demographics
NPI:1851539159
Name:MIDWEST INJURY & PAIN, PLLC
Entity Type:Organization
Organization Name:MIDWEST INJURY & PAIN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSOUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-310-7262
Mailing Address - Street 1:160 MERIBAH
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-2716
Mailing Address - Country:US
Mailing Address - Phone:248-310-7262
Mailing Address - Fax:517-546-4699
Practice Address - Street 1:113 N MICHIGAN AVE
Practice Address - Street 2:A3
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2283
Practice Address - Country:US
Practice Address - Phone:248-310-7262
Practice Address - Fax:517-546-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008000111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty