Provider Demographics
NPI:1902217474
Name:CENTER FOR PAIN MEDICINE, P.A.
Entity Type:Organization
Organization Name:CENTER FOR PAIN MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-388-3947
Mailing Address - Street 1:2401 41ST ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7783
Mailing Address - Country:US
Mailing Address - Phone:701-551-6980
Mailing Address - Fax:
Practice Address - Street 1:2401 41ST ST S
Practice Address - Street 2:101
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-7783
Practice Address - Country:US
Practice Address - Phone:701-388-3947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-18
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9776261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1689691545OtherNPI