Provider Demographics
NPI:1942802293
Name:ADVANCED PAIN SPECIALIST OF MICHIGAN PLLC
Entity Type:Organization
Organization Name:ADVANCED PAIN SPECIALIST OF MICHIGAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:HODROJ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:313-467-4466
Mailing Address - Street 1:34020 7 MILE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3093
Mailing Address - Country:US
Mailing Address - Phone:248-516-5016
Mailing Address - Fax:786-640-0605
Practice Address - Street 1:34020 7 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3093
Practice Address - Country:US
Practice Address - Phone:786-640-0604
Practice Address - Fax:786-640-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty