Provider Demographics
NPI:1922041276
Name:DOLORA PAIN MANAGEMENT ASSOCIATES, PC
Entity Type:Organization
Organization Name:DOLORA PAIN MANAGEMENT ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYEED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-755-4333
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48303-0432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27301 SCHOENHERR RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6649
Practice Address - Country:US
Practice Address - Phone:586-755-4333
Practice Address - Fax:586-755-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI050086702OtherRAILROAD MEDICARE
6355950001Medicare NSC
MI050086702OtherRAILROAD MEDICARE