Provider Demographics
NPI:1861819161
Name:MICHIGAN INTERVENTIONAL PAIN ASSOCIATES PLLC
Entity Type:Organization
Organization Name:MICHIGAN INTERVENTIONAL PAIN ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-624-7246
Mailing Address - Street 1:2300 HAGGERTY RD STE 2100
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2191
Mailing Address - Country:US
Mailing Address - Phone:248-624-7246
Mailing Address - Fax:248-624-2597
Practice Address - Street 1:2300 HAGGERTY RD
Practice Address - Street 2:SUITE 2100
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2184
Practice Address - Country:US
Practice Address - Phone:248-624-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty