Provider Demographics
NPI:1700350287
Name:SOUTHERN PAIN & SPINE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:SOUTHERN PAIN & SPINE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMRIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-704-7246
Mailing Address - Street 1:101 E MATTHEWS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5373
Mailing Address - Country:US
Mailing Address - Phone:833-704-7246
Mailing Address - Fax:
Practice Address - Street 1:101 E MATTHEWS ST STE 200
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5373
Practice Address - Country:US
Practice Address - Phone:833-704-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty